Published online before print May 30, 2006, doi: 10.1161/01.HYP.0000227029.10536.e8
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(Hypertension. 2006;48:40.)
© 2006 American Heart Association, Inc.
Original Articles |
Effects of Childhood Primary Hypertension on Carotid Intima Media Thickness
A Matched Controlled Study
From the Divisions of Pediatric Nephrology (M.B.L.) and Pediatric Cardiology (C.C.M.), Department of Pediatrics, Department of Radiology (N.L.C.), and Department of Biostatistics and Computational Biology (J.R.), University of Rochester Medical Center, NY.
Correspondence to Marc B. Lande, 601 Elmwood Ave, Box 777, Rochester, NY 14642. E-mail marc_lande{at}urmc.rochester.edu
To determine whether carotid intima media thickness is increased in children with primary hypertension, the current study compared carotid intima media thickness in hypertensive children with that of normotensive control subjects matched closely for body mass index and determined the relationship between carotid intima media thickness and hypertension severity determined by ambulatory blood pressure monitoring. Children with newly diagnosed office hypertension (n=28) had carotid intima media thickness, left ventricular mass index, and ambulatory blood pressure monitoring performed. Carotid intima media thickness was performed in normotensive control subjects (n=28) matched pairwise to hypertensive subjects for age (±1 year), gender, and body mass index (±10%). Eighty-two percent of subjects were overweight or obese (body mass index 
85th percentile). The median carotid intima media thickness of hypertensive subjects was greater than that of matched controls (0.67 versus 0.63 mm; P=0.045). In the hypertensive subjects, carotid intima media thickness correlated strongly with several ambulatory blood pressure monitoring parameters, with the strongest correlation for daytime systolic blood pressure index (r=0.57; P=0.003). In the hypertensive group, the prevalence of left ventricular hypertrophy was 32%, but unlike carotid intima media thickness, left ventricular mass index did not correlate with ambulatory blood pressure monitoring. Together, the findings that hypertensive subjects had increased carotid intima media thickness compared with matched controls and that higher carotid intima media thickness correlated with more severe hypertension by ambulatory blood pressure monitoring provide strong evidence that carotid intima media thickness is increased in childhood primary hypertension, independent of the effects of obesity.
Key Words: carotid arteries • children • hypertension, obesity
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Hypertension 2006 48: 23-24.
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