Published online before print October 19, 2009, doi: 10.1161/HYPERTENSIONAHA.109.139949
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2009;54:1234.)
© 2009 American Heart Association, Inc.
Original Articles |
Accelarated Skeletal Maturation in Children With Primary Hypertension
From the Departments of Biochemistry and Experimental Medicine (P.P., M.J., E.Kr., E.Ka., A.W., R.S.L.), Nephrology and Arterial Hypertension (M.L., A.N., J.S.), Research (M.L.), and Gastroenterology, Hepatology, and Immunology (J.N.-M.), Children’s Memorial Health Institute, Warsaw, Poland.
Correspondence to Mieczyslaw Litwin, Department of Nephrology and Arterial Hypertension, Department of Research, Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland. E-mail m.litwin{at}czd.pl
It is hypothesized that primary hypertension (PH) is a disorder with origins in childhood linked to, at least in part, aberrations of growth and maturation processes. To evaluate the possible relation between the rate of biological maturity and development of PH, bone age (BA) assessments on the basis of dual x-ray absorptiometry–derived hand scans were performed in 54 newly diagnosed children and adolescents with PH and 54 healthy controls matched for body mass index (BMI), age and sex. Chronological age (CA), body height (in centimeters), body weight (in kilograms), BMI (in kilograms per meter squared), and blood pressure were assessed. Healthy controls had a mean BA of 14.7±2.3 years that was not significantly different from their mean CA of 14.2±2.1 years. In the PH group, the BA of 16.0±2.0 years was higher by 1.9±0.9 years compared with their CA of 14.1±2.0 years (P<0.0001). The magnitude of acceleration of skeletal maturation (BA-CA) and its prevalence (88.9%) were significantly higher in PH compared with BMI-matched controls (37.0%; 
2=31.4; P<0.0001). BA-CA values of PH patients were higher by 1.24 years in normal weight (P<0.0001), 1.80 years in overweight (P<0.01), and 1.40 years in obese (P<0.0001) subgroups of BMI z score–matched controls. Stepwise regression revealed that predictors of blood pressure status from normotension through prehypertension stages 1 and 2 of hypertension were BA-CA (β=0.530; P<0.0.001), height (β=–0.379; P<0.01), and CA (β=0.298; P<0.05; R2=0.43). In conclusion, irrespective of BMI, advanced biological maturation should be considered as an independent marker for the development of hypertension.
Key Words: bone age • hand densitometry • children • hypertension • biological maturity
Related Article:
Hypertension 2009 54: 1204-1205.
This article has been cited by other articles:
 |
|
 |
|
  J. T. Flynn Hypertension, Growth, and Skeletal Maturation in the Young: A New Look at an Old Idea Hypertension, December 1, 2009; 54(6): 1204 - 1205. [Full Text] [PDF]
|
|