What is the clinical evidence from this study?

Study design: Observational. Population: Essential hypertension (n=77). Intervention: Essential hypertension vs. Healthy controls. Primary outcome: Carotid-femoral pulse wave velocity (cfPWV) (p=0.001).

July 21, 2021Open Access

Ultrasonography to detect cardiovascular damage in children with essential hypertension

Resultado clave

Children with essential hypertension had significantly higher carotid-femoral pulse wave velocity (5.4 m/s vs 4.6 m/s, p=0.001) compared to healthy controls, indicating early vascular damage.

Diseño del estudio

Tipo

Observational (n=77)

Enmascaramiento

Double-blind

Multicéntrico

PICO estructurado

Does ultrasonography detect early cardiovascular structural and functional damage in children with essential hypertension compared to healthy controls?

Población

77 children, including 45 with newly diagnosed essential hypertension (34 simple hypertension, 11 hypertension co-existing with obesity) and 32 healthy age- and sex-matched controls from the community.

Intervención

Ultrasonography (echocardiography and pulse-wave Doppler) to measure cardiovascular structure and function

Comparador

Healthy children matched for age and sex

Resultado

Changes in cardiovascular structure and function (cfPWV, cIMT, CD, LAD, LVM, LVMI, RWT, LVIDd, IVSd, LVPWd, AO, E peak, A peak, E' peak, A' peak, E/E' ratio, and E/A ratio)surrogate

Children and adolescents with essential hypertension demonstrate early target organ damage in the heart and blood vessels that can be detected noninvasively using ultrasonography.

Resultado numérico

Tasa de eventos absoluta: 5.4% vs 4.6%

valor p: p=0.001

Limitaciones

Retrospective study design with inevitable selection bias
Small sample size with uneven regional distribution
Missing parameters for a simple obesity control group
Lack of intra- and inter-operator variability data for cfPWV assessment
No agreement data between the Doppler technique and tonometry or piezoelectric mechano-transducer technique

Resumen

BACKGROUND: Essential hypertension in adults may begin in childhood. The damages to the heart and blood vessels in children with essential hypertension are hidden and difficult to detect. We noninvasively examined changes in cardiovascular structure and function in children with hypertension at early stage using ultrasonography. METHODS: All patients with essential hypertension admitted from March 2020 to May 2021 were classified into simple hypertension (group 1, n = 34) and hypertension co-existing with obesity (group 2, n = 11) isolation. Meanwhile 32 healthy children were detected as control heathly group (group 3). We used pulse-wave Doppler to measure carotid-femoral pulse wave velocity (cfPWV), intimal-medial thickness (cIMT) and distensibility of carotid artery (CD). Cardiac structure and function (left atrial diameter LAD, left ventricular mass LVM, LVM index LVMI, relative wall thicknes RWT, end-diastolic left ventricular internal diameter LVIDd, diastolic interventricular septum thickness IVSd, diastolic left ventricular posterior wall thickness LVPWd, root diameter of aorta AO, E peak, A peak, E' peak, A' peak, E/E' ratio, and E/A ratio) were measured by echocardiography. RESULTS: The cfPWV of children in group 1 and group 2 were significantly higher than healthy children in group 3. Significant differences were observed in LVM, LVMI, RWT, LVIDd, IVSd, LVPWd, LAD, A peak, E' peak, A' peak, and E/E' among three groups. CONCLUSION: Children and adolescents with essential hypertension demonstrate target organ damages in the heart and blood vessels.

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo