Key result
BMI links to left ventricular remodeling more strongly than blood pressure in hypertensive children.
Why the study?
Hypertension in children predicts adult persistence, making early diagnosis crucial to reduce cardiovascular morbidity before organ damage occurs, but its risk factors, evolution, and associated cardiac damage require investigation.
Cohort (n=92)
No
p-value: p=0.001
In children monitored for hypertension, body mass index is a stronger predictor of left ventricular mass than blood pressure values, emphasizing the need for early weight management to prevent cardiac organ damage.
BMI reduction may limit cardiac remodeling in hypertensive children beyond BP control; leaves open need for interventional confirmation.
BACKGROUND: Hypertension (HTN) is a well-established cardiovascular (CV) risk factor in adults. The presence of HTN in children appears to predict its persistence into adulthood. Early diagnosis of HTN is crucial to reduce CV morbidity before the onset of organ damage. AIM: The aim of this study is to investigate cardiac damage in HTN, its risk factors (RFs), and evolution. METHODS: We conducted a prospective/retrospective study involving children referred to the Childhood Hypertension Outpatient Clinic. This study included clinical and echocardiographic assessments of cardiac morphology and function at three time points: enrollment (T0) and follow-up (T1 and T2). RESULTS: Ninety-two patients (mean age 11.4 ± 3 years) were enrolled. Cardiac eccentric and concentric hypertrophy were present in 17.9% and 9%, respectively, with remodeling in 10.5%. Overweight/obese subjects exhibited significantly higher systolic blood pressure (SBP), frequency of HTN, and body mass index (BMI) at T0 compared with patients with chronic kidney disease (CKD). SBP and BMI persisted more during follow-up. Normal-weight vs. overweight/obese patients were significantly more likely to have normal geometry. Positive correlations were found between BMI and left ventricular (LV) mass at T0, BMI and SBP at T0 and T1. Gender, BMI, SBP, and diastolic blood pressure (DBP) significantly predicted LV mass index (LVMI), but only BMI added significance to the prediction. During follow-up, the variation of BMI positively correlated with the variation of SBP, but not with LVMI. CONCLUSIONS: In our cohort, body weight is strongly associated with HTN and cardiac mass. Importantly, the variation in body weight has a more significant impact on the consensual variation of cardiac mass than blood pressure (BP) values. A strict intervention on weight control through diet and a healthy lifestyle from early ages might reduce the burden of CV morbidity in later years.
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Fabi et al. (2023) conducted a cohort in Hypertension (n=92). Higher Body Mass Index (BMI) vs. Normal weight was evaluated on Prediction of left ventricular mass index (LVMI 2.16) (p=0.001). In a cohort of children monitored for hypertension, body mass index was the only significant independent predictor of left ventricular mass index (p=0.001), indicating a stronger association with cardiac remodeling than blood pressure levels.
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