Key result
Grade 2 office hypertension linked to ~4.2-fold higher odds of LVH in untreated pediatric hypertension.
Why the study?
Left ventricular hypertrophy is a common cardiac target-organ damage in children with primary hypertension, and ambulatory blood pressure monitoring may provide additional diagnostic information beyond office blood pressure.
Are specific clinical and ambulatory blood pressure monitoring-derived factors associated with left ventricular hypertrophy in untreated children with primary hypertension?
Observational (n=306)
Are specific clinical and ambulatory blood pressure monitoring-derived factors associated with left ventricular hypertrophy in untreated children with primary hypertension?
In untreated children with newly diagnosed primary hypertension, grade 2 office hypertension is the strongest predictor of left ventricular hypertrophy, while ABPM-derived systolic non-dipping patterns provide independent predictive value.
May prompt closer LVH surveillance in untreated children with grade 2 hypertension; leaves open whether ABPM thresholds should guide therapy.
To identify clinical and ambulatory blood pressure monitoring (ABPM)-derived factors associated with left ventricular hypertrophy (LVH) in untreated children and adolescents with primary hypertension. This retrospective study included 306 untreated patients aged 9–17 years with newly diagnosed primary hypertension. LVH was defined as a left ventricular mass index ≥ 45 g/m^2.16. Propensity score-based overlap weighting was used to balance demographic and obesity-related characteristics between patients with and without LVH. Weighted logistic regression was performed to evaluate clinical, laboratory, and ABPM-derived factors associated with LVH. LVH was present in 89 patients (29.1%). Grade 2 office hypertension was the strongest factor associated with LVH (OR 4.22, 95% CI 2.29–7.77; P < 0.001). Selected metabolic and inflammatory markers showed exploratory associations with LVH. Among continuous ABPM parameters, nighttime mean diastolic blood pressure was associated with LVH (OR 1.54 per 10-mmHg increase, 95% CI 1.02–2.31), although this association was lost after adjustment for hypertension grade. In contrast, a systolic non-dipper pattern remained associated with LVH after adjustment for hypertension grade (OR 2.83, 95% CI 1.18–6.80; P = 0.020). Conclusion : LVH was common among untreated children with primary hypertension, with office HTN severity being the predominant associated factor. Abnormal circadian BP patterns may provide complementary information for identifying children with LVH. What is Known: • Left ventricular hypertrophy is a common form of cardiac target-organ damage in children with primary hypertension. • Ambulatory blood pressure monitoring provides information on nocturnal blood pressure and circadian patterns beyond office blood pressure. What is New: • In untreated children, grade 2 office hypertension was the factor most strongly associated with left ventricular hypertrophy. • A systolic non-dipping pattern remained associated with left ventricular hypertrophy after adjustment for hypertension severity, suggesting additional value of circadian blood pressure assessment.
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Zhu et al. (2026) conducted an observational in Primary hypertension (n=306). Grade 2 office hypertension vs. Lower grade or absent office hypertension was evaluated on Left ventricular hypertrophy (LVH) (OR 4.22, 95% CI 2.29-7.77, p=<0.001). In untreated children with primary hypertension, grade 2 office hypertension was the strongest factor associated with left ventricular hypertrophy (OR 4.22; 95% CI 2.29-7.77; P<0.001).
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