Assessment of Vascular Function in Hypertensive Children

描述（由申请人提供）： 高血压及其相关的合并症是美国的主要死亡原因之一。虽然中风和心脏病发作等硬性终点需要数年时间才能发生，但很明显，这种疾病过程在生命中很早就开始了。在过去的十年中，我国儿童高血压和肥胖症的患病率显著增加，这导致了关于该患者人群的治疗和长期结果的问题。传统的终点在儿童中没有什么价值，因此重点转向替代标志物，如左心室肥大、颈动脉内膜中层厚度和尿微量白蛋白。本研究的目的是更好地确定高血压和功能性血管异常之间的关系-特别是肱动脉血流介导的扩张和大小血管动脉顺应性，通过桡动脉脉搏波轮廓分析测量。通过测量根据高血压严重程度分层的高血压儿童和匹配的对照组的这些参数，我们计划表明，内皮依赖性血管舒张反应是抑郁依赖于高血压的严重程度，并在小动脉和大动脉的顺应性相应降低。

DESCRIPTION (provided by applicant): Hypertension with its related comorbidities is one of the leading causes of death in the US. While it takes years for hard endpoints such as stroke and heart attack to occur, it has become clear that this disease process begins much earlier in life. The prevalence of hypertension and obesity among our nation's children has increased significantly over the last decade leading to questions regarding treatment and long term outcomes in this patient population. Conventional endpoints are of little value in children so focus has turned to surrogate markers such as left ventricular hypertrophy, carotid artery intimal medial thickness, and microabluminuria. This study's aim is to better define the relationship between hypertension and functional vascular abnormalities - specifically brachial artery flow mediated dilatation and small and large vessel arterial compliance as measured by radial pulse wave contour analysis. By measuring these parameters in hypertensive children stratified according to severity of hypertension and matched controls, we plan to show that endothelial dependent vasodilatory response is depressed dependent on the severity of hypertension and that compliance in both small and large arteries in decreased accordingly.