Ultrasonography to detect cardiovascular damage in children with essential hypertension

Liu, Wei; Hou, Cui; Miao, Heng; Xu, Qian; Wang, Hui; Gu, Pei-Pei; Lv, Haitao; Ding, Yueyue

doi:10.1186/s12947-021-00257-y

Cited by 6 publications

(13 citation statements)

References 31 publications

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“…1). The final analysis included a total of 22 studies [3,16–36] including 3460 children [48% (1651/3460) had elevated BP], aged between 5 and 21 years. Selected studies are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Systolic and diastolic left ventricular function in children with primary hypertension: a systematic review and meta-analysis

Rus

Pac

Obrycki

et al. 2022

Journal of Hypertension

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Objective:Evaluation of left ventricular function provides early evidence of target-organ damage in children with primary hypertension. We performed a systematic review and meta-analysis of left ventricular systolic and diastolic function in children and adolescents with primary hypertension.Methods:Literature search was performed in PubMed database and out of 718 articles (published between 2000 and 2021) 22 studies providing comparison of left ventricular function parameters between children with primary hypertension and normotensive controls were selected.Results:Overall, 3460 children (5–21 years) with primary hypertension were analyzed. Meta-analysis showed that hypertensive patients when compared with normotensives, had an increased heart rate (mean difference [MD] 5.59; 95% confidence interval [CI] 3.28, 7.89; 10 studies) and increased fractional shortening (MD 1.04; 95% CI 0.48, 1.60; 9 studies) but did not differ in ejection fraction (MD −0.03; 95% CI −1.07, 1.02; 12 studies). Stroke volume was higher in one out of three studies, whereas no differences in cardiac output were found in two studies with available data. Hypertensive children had also lower E/A values (MD −0.21; −0.33, −0.09; 14 studies), greater values of E/e′ (MD 0.59; 0.36, 0.82; 8 studies) and greater global longitudinal stress (MD 2.50; 2.03, 2.96; 4 studies) when compared to those with normotension.Conclusion:Our results indicate that hypertensive children and adolescents present with signs of hyperkinetic function of the left ventricle, demonstrate evidence of increased left ventricular strain and impaired diastolic function compared to normotensive controls.

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Section: Resultsmentioning

confidence: 99%

“…H ypertensive children often present with markers of hypertension mediated organ damage (HMOD) at the time of initial diagnosis of primary hypertension (PH) [1][2][3]. Left ventricular hypertrophy (LVH) and subclinical hypertensive arterial injury have been shown to be present in 40% of children when diagnosed with PH [4].…”

Section: Introductionmentioning

confidence: 99%

Systolic and diastolic left ventricular function in children with primary hypertension: a systematic review and meta-analysis

Rus

Pac

Obrycki

et al. 2022

Journal of Hypertension

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“…Three were community screening-based cohorts ( 17 , 30 , 50 ), 41 reported data from pediatric HT specialty clinics, and four reported mixed data from both ( 31 , 42 , 45 , 56 ). LVH was defined as LVMI above 95th percentile in 22 (47%) studies ( 17 , 18 , 21 , 23 , 25 – 28 , 32 – 34 , 37 , 44 , 46 , 47 , 50 – 53 , 57 , 60 , 61 ), fixed cut-off ≥38.6 g/m 2.7 in eight (17%) ( 19 , 24 , 36 , 40 , 43 , 45 , 49 , 55 ), sex-specific fixed cut-offs (≥36.88 g/m 2.7 and ≥39.36 g/m 2.7 for female and male subjects, respectively) in six (13%) ( 29 , 35 , 38 , 39 , 41 , 48 ), one used magnetic resonance imaging (MRI) ( 58 ), while the remaining were heterogeneous. Ethnicity was reported in 27 (61%) studies.…”

Section: Resultsmentioning

confidence: 99%

“…(ii) Subgroup 2: additionally including study cohorts reporting data from pediatric HT specialty clinics only that defined LVH by a fixed cut-off of 38.6 g/m 2.7 . Twenty-nine study cohorts (25 studies) ( 18 , 19 , 21 , 23 – 25 , 27 , 28 , 32 , 34 , 36 , 37 , 40 , 43 , 44 , 46 , 47 , 49 – 53 , 55 , 60 , 61 ) were included with a total of 1,940 subjects. The estimated pooled prevalence of LVH was 31.4% and heterogeneity was similarly high ( I 2 = 79%) ( Supplementary Figure S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Left ventricle geometry was reported in eight studies from specialty clinics that included 996 participants (mean age 13 years, 72% male subjects) with an overall prevalence of LVH at 34.2% ( I 2 = 70%). The prevalence of concentric remodeling was 9.0% ( I 2 = 88%), concentric LVH was 11.2% ( I 2 = 94%), and that of eccentric LVH was 21.6% ( I 2 = 0%) ( Figure 4 ) ( 16 , 19 , 22 , 27 , 35 , 46 , 49 , 61 ). In addition, one study with an overall prevalence of LVH of 18.9% reported LV geometry data for children identified by community screening ( 17 ).…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of left ventricular hypertrophy in children and young people with primary hypertension: Meta-analysis and meta-regression

Sinha

Ažukaitis²,

Śladowska-Kozłowska³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundLeft ventricular hypertrophy (LVH) is the main marker of HMOD in children and young people (CYP). We aimed to assess the prevalence of LVH and its determinants in CYP with primary hypertension (PH).MethodsA meta-analysis of prevalence was performed. A literature search of articles reporting LVH in CYP with PH was conducted in Medline, Embase, and Cochrane databases. Studies with a primary focus on CYP (up to 21 years) with PH were included. Meta-regression was used to analyze factors explaining observed heterogeneity.ResultsThe search yielded a total of 2,200 articles, 153 of those underwent full-text review, and 47 reports were included. The reports evaluated 51 study cohorts including 5,622 individuals, 73% male subjects, and a mean age of 13.6 years. LVH was defined as left ventricle mass index (LVMI) ≥ 95th percentile in 22 (47%), fixed cut-off ≥38.6 g/m2.7 in eight (17%), sex-specific fixed cut-off values in six (13%), and miscellaneously in others. The overall prevalence of LVH was 30.5% (95% CI 27.2–33.9), while heterogeneity was high (I2 = 84%). Subgroup analysis including 1,393 individuals (76% male subjects, mean age 14.7 years) from pediatric hypertension specialty clinics and LVH defined as LVMI ≥95th percentile only (19 study cohorts from 18 studies), reported prevalence of LVH at 29.9% (95% CI 23.9 to 36.3), and high heterogeneity (I2 = 84%). Two studies involving patients identified through community screening (n = 1,234) reported lower LVH prevalence (21.5%). In the meta-regression, only body mass index (BMI) z-score was significantly associated with LVH prevalence (estimate 0.23, 95% CI 0.08–0.39, p = 0.004) and accounted for 41% of observed heterogeneity, but not age, male percentage, BMI, or waist circumference z-score. The predominant LVH phenotype was eccentric LVH in patients from specialty clinics (prevalence of 22% in seven studies with 779 participants) and one community screening study reported the predominance of concentric LVH (12%).ConclusionLeft ventricular hypertrophy is evident in at least one-fifth of children and young adults with PH and in nearly a third of those referred to specialty clinics with a predominant eccentric LVH pattern in the latter. Increased BMI is the most significant risk association for LVH in hypertensive youth.

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The association of blood pressure, body mass index and carotid intima‐media thickness as childhood predictors of cardiovascular disease risk: A systematic review and meta‐analysis

Agyei,

Wiafe,

Donkor

et al. 2024

Health Science Reports

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Background and AimsBlood pressure, body mass index (BMI), and carotid intima‐media thickness (CIMT) are well‐known independent predictors of cardiovascular disease especially in adulthood. However, there is insufficient evidence regarding the statistical significance of the relationship between childhood CIMT, blood pressure and BMI. This systematic review and meta‐analysis was therefore conducted to ascertain the relationship.MethodsThis systematic review and meta‐analysis was reported in accordance with the PRISMA statement. Three electronic databases were searched, namely EMBASE, MEDLINE and the Cochrane Library. Data were extracted independently by two review authors. Quantitative data were analyzed using Review Manager.ResultsThe meta‐analysis was conducted using a random effects model and standard mean difference. The results of the meta‐analysis indicated a statistically significant difference in CIMT of 0.86 (95% CI: 0.41–1.31) between normotensive versus hypertensive children. Again, overweight and moderately obese children had higher CIMT values as compared to normal weight children with a pooled standard mean difference of 0.72 (95% CI: 0.24–1.20) and 2.75 (95% CI: 0.73–4.77) respectively. The pooled standard mean difference of systolic and diastolic blood pressures was found to be 2.44 (95% CI: 1.69–3.19) and 1.28 (95% CI: 0.65–1.92) respectively between normal weight and overweight/obese children.ConclusionThe meta‐analysis found a significant difference in CIMT between normotensive and hypertensive children, with overweight and moderately obese children having higher CIMT values. Thus, conducting CIMT screening for obese or overweight children and children with increased blood pressure can provide valuable information about their cardiovascular disease risk.

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Ultrasonography to detect cardiovascular damage in children with essential hypertension

Cited by 6 publications

References 31 publications

Systolic and diastolic left ventricular function in children with primary hypertension: a systematic review and meta-analysis

Systolic and diastolic left ventricular function in children with primary hypertension: a systematic review and meta-analysis

Prevalence of left ventricular hypertrophy in children and young people with primary hypertension: Meta-analysis and meta-regression

The association of blood pressure, body mass index and carotid intima‐media thickness as childhood predictors of cardiovascular disease risk: A systematic review and meta‐analysis

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