Evaluation of arterial stiffness and carotid intima-media thickness in children with primary and renal hypertension

Hypertension is an increasing disease in children and the risk of endothelial damage and target organ damage increases in the presence of additional risk factors such as obesity. In our study, early atherosclerotic changes and target organ damage were investigated in hypertensive children. Twenty four-hour ambulatory pulse wave analysis was performed by oscillometric method in 17 patients with primary hypertension, 18 obese patients with primary hypertension, and 16 patients with renal hypertension. Carotid intima- media thickness and left ventricular mass index were measured. The control group included 20 age- and sex-matched healthy children. Central systolic blood pressure, central diastolic blood pressure, systolic blood pressure and diastolic blood pressure were higher in the primary hypertension group compared to controls (p = 0.001, p = 0.005, p = 0.001, p = 0.009, respectively), central systolic blood pressure was higher in the renal hypertension group than the control group (p = 0.018). There was no difference between the two groups in terms of pulse wave analysis parameters, carotid intima-media thickness, or left ventricular mass index (p > 0.05). Pulse wave velocity was positively correlated with systolic blood pressure, diastolic blood pressure, central systolic blood pressure, central diastolic blood pressure (p < 0.001). Augmentation index was positively correlated with DBP and cDBP (p = 0.01, p = 0.002, respectively). Our findings show that high blood pressure is associated with arterial stiffness and target organ damage. Pulse wave analysis is a reliable and non-invasive method that can be used to prevent target organ damage in hypertensive children by detecting early atherosclerotic changes and thus allowing to take necessary precautions such as lifestyle changes.