Open AccessCardiac and Vascular Consequences of Pre‐Hypertension in Youth
Author(s) -
Urbina Elaine M.,
Khoury Philip R.,
McCoy Connie,
Daniels Stephen R.,
Kimball Thomas R.,
Dolan Lawrence M.
Publication year - 2011
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2011.00471.x
Subject(s) - medicine , cardiology , arterial stiffness , blood pressure , pulse wave velocity , body mass index , brachial artery , diastole , essential hypertension , pulse pressure , intima media thickness , end organ damage , diabetes mellitus , common carotid artery , carotid arteries , endocrinology
Hypertension is associated with increased left ventricular mass (LVM) and carotid intima‐media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre‐hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C‐reactive protein, LVM/height 2.7 (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre‐hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre‐hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre‐hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre‐hypertension is associated with cardiovascular target organ damage in adolescents and young adults. J Clin Hypertens (Greenwich). 2011;13:332–342. ©2011 Wiley Periodicals, Inc.