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Left ventricle hypertrophy and re-modeling in children with essential hypertension: does the race matter?

Published online by Cambridge University Press:  16 November 2023

Daiji Takajo Open the ORCID record for Daiji Takajo [Opens in a new window] ,
Thomas S. Przybycien ,
Preetha L. Balakrishnan ,
Girija Natarajan Open the ORCID record for Girija Natarajan [Opens in a new window] ,
Gautam K. Singh  and
Sanjeev Aggarwal
Daiji Takajo*
Affiliation:
Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Thomas S. Przybycien
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Preetha L. Balakrishnan
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Girija Natarajan
Affiliation:
Division of Neonatal & Perinatal Medicine, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Gautam K. Singh
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Sanjeev Aggarwal
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
*
Corresponding author: D. Takajo; Email: daiji.takajo@cchmc.org
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Abstract

Background:

This is the first study to report on the impact of race on differences in the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at the time of diagnosis of essential hypertension in children.

Methods:

This cross-sectional, single-centre study included patients aged 3–18 years who had newly diagnosed essential hypertension. Echocardiography was used to assess left ventricular mass index and left ventricular relative wall thickness. An left ventricular mass index > the 95th percentile for age and gender, and an left ventricular relative wall thickness > 0.42, were used to diagnose left ventricular hypertrophy and concentric adaptation. Various echocardiographic parameters were compared between African Americans and Caucasians.

Results:

The study included 422 patients (289 African Americans and 133 Caucasians) diagnosed with essential hypertension at a median age of 14.6 (interquartile range; 12.1–16.3) years. Eighty-eight patients (20.9%) had left ventricular hypertrophy. There was no statistically significant difference in the prevalence of left ventricular hypertrophy between African Americans and Caucasians (22.5% versus 17.3%, p=0.22). The median left ventricular relative wall thickness was 0.35 (0.29–0.43), and 114 patients (27.0%) had an left ventricular relative wall thickness > 0.42. The presence of an left ventricular relative wall thickness > 0.42 was significantly higher among African Americans compared to Caucasians (30.1% versus 20.3%, p = 0.04). The African American race was a strong predictor for an left ventricular relative wall thickness > 0.42 (odds ratio 1.7, p = 0.04), but not for left ventricular mass index > the 95th percentile (p = 0.22). Overweight/obesity was a strong predictor for an left ventricular mass index > the 95th percentile.

Conclusions:

There was no difference in the prevalence of left ventricular hypertrophy in children with essential hypertension of different races. Obesity, rather than being African American, is associated with left ventricular hypertrophy.

Keywords

left ventricular hypertrophychildrenessential hypertensionobesityconcentric adaptation
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 4 , April 2024 , pp. 906 - 913
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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