What is the clinical evidence from this study?

Study design: Cohort. Population: Left ventricular hypertrophy risk (n=146). Primary outcome: Follow-up left ventricular mass and midwall fractional shortening.

What question did this study set out to answer?

To identify hemodynamic and stress-reactivity predictors of cardiac structure and function over time in a biracial youth cohort.

November 1, 1999HypertensionOpen Access

Hemodynamic Function at Rest, During Acute Stress, and in the Field

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Key result

Initial left ventricular mass, body mass index, male gender, and supine resting total peripheral resistance independently predicted follow-up left ventricular mass in youth (R2=0.53).

Population

146 youth aged initially 10 to 19 years (mean age, 14.2+/-1.8 years), including black and white youth.

Design

Cohort

Follow-up

2.3 years

Authors

GKGaston KapukuAugusta University FTFrank A. TreiberPreventive Cardiology HDHarry DavisUniversity of Maryland, Baltimore

Discussion

Member takes

Implication

May aid risk stratification in youth with hypertension; hypothesis-generating and requires prospective trials before informing care.

Key Points

To identify hemodynamic and stress-reactivity predictors of cardiac structure and function over time in a biracial youth cohort.
Assessed 146 youth aged 10 to 19 years (mean 14.2±1.8 years) at baseline and after a 2.3-year follow-up interval.
Evaluated hemodynamics at rest, during acute laboratory stressors (orthostasis, car-driving simulation, video game, forehead cold), and via ambulatory blood pressure monitoring.
Obtained quantitative M-mode echocardiograms at both visits and evaluated predictors using hierarchical stepwise regression analysis.
Black youth compared to white youth had higher resting systolic blood pressure (P<0.02), greater relative wall thickness (P<0.003), greater left ventricular mass indexed to body surface area or height^2.7 (P<0.01 for both), and lower midwall fractional shortening (P<0.05).
Follow-up left ventricular mass indexed to height^2.7 was independently predicted by baseline mass, body mass index, male sex, and resting total peripheral resistance (model R²=0.53).
Follow-up left ventricular mass indexed to body surface area was predicted by baseline mass, weight, male sex, resting total peripheral resistance, and systolic response to simulated driving (model R²=0.48).

Study Design

Type

Cohort (n=146)

Structured PICO

Population

146 youth aged initially 10 to 19 years (mean age, 14.2+/-1.8 years), including black and white youth.

Outcome

Left ventricular mass and midwall fractional shortening measured by quantitative M-mode echocardiography at 2.3 years follow-up.surrogate

In youth, baseline left ventricular mass, body mass index, male gender, and resting total peripheral resistance independently predict future left ventricular mass over a 2.3-year period.

Limitations

The clinical significance of these findings and their implications for improved prevention of cardiovascular diseases are yet to be determined.

Cite This Study

Kapuku et al. (1999) conducted a cohort in Left ventricular hypertrophy risk (n=146). Initial left ventricular mass, body mass index, male gender, and supine resting total peripheral resistance independently predicted follow-up left ventricular mass in youth (R2=0.53).

synapsesocial.com/papers/6a1555a49b87f33fc69f758b https://doi.org/10.1161/01.hyp.34.5.1026

View Full Paper

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Bookmark

Hemodynamic Function at Rest, During Acute Stress, and in the Field

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Hemodynamic Function at Rest, During Acute Stress, and in the Field

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider