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(Hypertension. 2006;48:23.)
© 2006 American Heart Association, Inc.

Editorial Commentary

What Is the Significance of Increased Carotid Intima Media Thickness in Hypertensive Adolescents?

Joseph T. Flynn

From the Pediatric Hypertension Program, Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY.

Correspondence to Division of Pediatric Nephrology, Montefiore Medical Center, 111 East 210th St, Bronx, NY 10467. E-mail jflynn@montefiore.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Fortunately, common cardiovascular sequelae of long-standing hypertension in adults, such as myocardial infarction and stroke, are not seen in hypertensive children and adolescents. However, it is well established that persistent blood pressure elevation in the young can produce other target-organ effects. Chief among these are left ventricular hypertrophy (LVH), which may be present in 30% of children at the time of diagnosis of hypertension,¹ and abnormal left ventricular geometry, which is typically seen in those with more severe blood pressure elevation. LVH can be seen even in adolescents with even mild blood pressure elevation and is probably the most readily assessed target-organ effect of hypertension in the young because of the wide availability of echocardiography. Its importance as a cardiovascular risk factor was recently highlighted by the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents, which recommended that echocardiograms be obtained as part of the initial evaluation of children and adolescents with confirmed hypertension.² It was further recommended that if LVH is found, the antihypertensive therapy should be intensified.

Other consequences of hypertension almost certainly develop in young hypertensive subjects but are more difficult to demonstrate. These include renal damage, hypertensive retinopathy, and cognitive impairment. Hypertensive renal damage probably first manifests as microalbuminuria and later progresses to end-stage renal disease; indeed, hypertension is one of the leading causes of chronic kidney disease in adults.³ In children, however, the incidence of renal damage from isolated hypertension has not been established, and although . . . [Full Text of this Article]

Related Article:

Effects of Childhood Primary Hypertension on Carotid Intima Media Thickness: A Matched Controlled Study

Marc B. Lande, Nancy L. Carson, Jason Roy, and Cecilia C. Meagher
Hypertension 2006 48: 40-44. [Abstract] [Full Text] [PDF]

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