Summary:
Background. Left ventricular hypertrophy is an independent risk factor of cardiovascular morbidity and mortality
in adults. The results of 24-hour ambulatory blood pressure monitoring (ABPM) correlate better with signs of organ
damage than values of casual blood pressure. The objective of this study was to investigate the relationships between
the results of 24-hour ABPM and left ventricular geometry in school-aged children and adolescents with elevated
blood pressure.
Methods and Results. 24-hour ABPM and echocardiographic assessment of left ventricle were performed in
108 children and adolescents age 8-20 years (77 boys and 31 girls) with repeatedly elevated casual blood pressure
(BP) values. Patients with secondary cause of hypertension were not included in this study. Based on ABPM results
57 patients out of total 108 had hypertension, the rest of 51 subjects had their ambulatory BP values below 95.
percentil and were labelled as white coat hypertensive (WCH). The left ventricular measurements in hypertensive
subject were higher when compared with WCH (left ventricle posterior wall thickness 8.4±1.0 mm in hypertensive
vs. 8.0±1.1 mm in WHC (p=0.047) and supurscript left ventricular mass index 81.8±13.8 g/m
2
vs 74.3±12 g/m
2
respectively; p=0,003). No differences were found in anthropometric data including body mass index in both groups.
There was a significant correlation between ambulatory BP and both left ventricle posterior wall thickness and left
ventricular mass index. The strongest correlation was found between diurnal systolic ambulatory BP and left ventricle
posterior wall thickness (r=0.42; p<0.001) as well as between 24-hour and diurnal systolic ambulatory BP and left
ventricular mass index (both r=0.47; p<0.001).
Conclusions. Both left ventricle posterior wall thickness a left ventricle mass index are higher in patients with
hypertension documented by ABPM compared with WCH subjects. The strongest correlation was found between
diurnal systolic ambulatory BP and both left ventricle posterior wall thickness and left ventricular mass index.
Key words:
ambulatory blood pressure monitoring, hypertension, white coat hypertension, left ventricular
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