Cardiovascular target organ damage could have been detected in sustained pediatric hypertension

Figures & data

Table I. Comparison of the characteristics between the follow-up and total hypertensive groups.

	Follow-up (n = 80)	Total (n = 128)	t/F/χ²	p
Male^a	41 (51.3)	61 (52.1)	0.015	0.903
Age (years)^b	11.4 ± 3.7	11.7 ± 4.0	–0.541	0.589
BMI (kg/m²)^c	25.7 ± 0.6	25.3 ± 0.5	0.265	0.607
WC (cm)^c	79.4 ± 1.3	79.3 ± 1.1	0.008	0.928
SBP (mmHg)^c	131.0 ± 1.3	129.0 ± 1.1	1.446	0.231
DBP (mmHg)^c	83.2 ± 1.2	82.3 ± 1.0	0.365	0.546
Obesitya	54 (67.5)	77 (65.8)	0.061	0.805

Data are shown as n (%) or mean ± SE.

BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure.

^aChi-squared analysis; ^bt test; ^ccovariance analysis adjusted for gender, age and puberty status (sperm for boys and menses for girls).

Table II. Characteristics of blood pressure groups at follow-up.

	Blood pressure changes
Index	Normotensive	Non-sustained hypertension	Sustained hypertension	F/χ²	p
n	152	38	48
Male^a	75 (49.3)	17 (44.7)	28 (58.3)	4.269	0.118
Age (years)^b	12.3 ± 0.2	12.2 ± 0.4	13.1 ± 0.3	2.684	0.07
Height (cm)^c	155.1 ± 0.6	156.9 ± 1.3	157.0 ± 1.1	1.448	0.237
Weight (kg)^c	50.3 ± 1.1	64.4 ± 2.1**	67.7 ± 1.9**	40.26	< 0.001
BMI (kg/m²)^c	20.3 ± 0.4	25.6 ± 0.7**	26.6 ± 0.6**	42.278	< 0.001
SBP (mmHg)^c	105 ± 1	115 ± 2**	131 ± 1^**††	140.43	< 0.001
DBP (mmHg)^c	65 ± 1	71 ± 1**	82 ± 1^**††	76.165	< 0.001
Overweight^a	36 (23.7)	2 (5.3)	9 (18.8)	39.852	< 0.001
Obesity^a	19 (12.5)	24 (63.2)	32 (66.7)	62.548	< 0.001

Data are shown as n (%) or mean ± SE.

^aTrend chi-squared test; ^bcovariance analysis adjusted gender and age; ^ccovariance analysis adjusted for gender, age and puberty status (sperm for boys and menses for girls).

Normotensive group as control: **p < 0.01; non-sustained hypertensive group as control: ††p < 0.01.

Table III. Levels of target organ damage (TOD) index in different groups of blood pressure changes.

	Blood pressure changes
Index	Normotensive	Non-sustained hypertension	Sustained hypertension	F	p
n	148	38	46	–	–
baPWV (cm/s)	926 ± 120	966 ± 115	1075 ± 182^**††	13.018	0
cfPWV (cm/s)	508 ± 80	492 ± 88	531 ± 144	3.166	0.45
LVM (g)	90 ± 26	106 ± 34**	126 ± 32**	4.281	0.015
LVMI (g/m²)	28 ± 6	32 ± 6**	34 ± 5**	4.208	0.016
RWT	0.36 ± 0.04	0.34 ± 0.05	0.34 ± 004	20923	0.056
cIMT (mm)	0.46 ± 0.03	0.47 ± 0.03**	0.49 ± 0.04**	5.052	0.007
hs-CRP (mg/l)^a	0.3 (0.2–1.1)	0.9 (0.2–2.7)	1.9 (0.5–3.6)*	2.253	0.108
mA1b/Cr (mg/mmol)^a	2.56 (0–12.3)	1.77 (1.3–14.3)	1.43 (1.1–10.3)	0.219	0.804
Cys-C (mg/l)	0.86 ± 0.01	0.89 ± 0.02	0.85 ± 0.02	1.596	0.205

Data are shown as mean ± SE or median (interquartile range).

^aLogarithmic transformation for non-normal distribution, described as median and quartile; other covariance analyses adjusted for gender, age, puberty status (sperm for boys and menses for girls) and body mass index, represented as mean ± SE.

baPWV, brachial–ankle PWV; cfPWV, carotid–femoral pulse-wave velocity; LVM, left ventricular mass; LVMI, left ventricular mass index; RWT, relative wall thickness; cIMT, carotid artery intima–media thickness; hs-CRP, high-sensitivity C-reactive protein; mA1b, microalbuminuria; Cys-C, cystatin-C.

Normotensive group as control: *p < 0.05, **p < 0.01; non-sustained hypertensive group as control: ††p < 0.01.

Table IV. Prevalence of target organ damage (TOD) in different groups of blood pressure changes.

	Blood pressure changes
Index	Normotensive	Non-sustained hypertension	Sustained hypertension	χ²	p
n	148	38	46	–	–
baPWV elevated	11 (9.2)	2 (6.1)	6 (14.6)	0.655	0.418
LVM elevated	12 (7.9)	16 (42.1)**	16 (33.3)**	23.066	< 0.001
LVMI elevated	3 (2.0)	4 (10.5)**	7 (14.6)^**††	11.913	0.001
RWT elevated	37 (24.3)	5 (13.2)	8 (16.7)	1.986	0.159
LVH	39 (25.7)	9 (27.7)	15 (33.3)	0.412	0.521
CA	19 (12.5)	12 (31.6)**	23 (47.9)^**††	27.973	< 0.001
hs-CRP elevated	14 (9.7)	8 (22.9)**	14 (31.1)^**††	13.028	< 0.001
mA1b/Cr elevated	18 (12.2)	2 (5.3)	0 (0)	1.208	0.547
Cys-C elevated	30 (20.7)	11 (31.4)	10 (22.2)	0.277	0.598
Kidney damage	61 (42.1)	12 (34.3)	17 (37.8)	0.456	0.5
Fundus artery stiffness	0	0	0	–	–

Data are shown as n (%).

baPWV, brachial–ankle PWV; LVM, left ventricular mass; LVMI, left ventricular mass index; RWT, relative wall thickness; LVH, left ventricular hypertrophy; CA, coronary arteriosclerosis; hs-CRP, high-sensitivity C-reactive protein; mA1b/Cr, microalbuminuria/creatinine; Cys-C, cystatin-C.

Trend chi-squared test; normotensive group as control: **p < 0.01; non-sustained hypertensive group as control: ††p < 0.01.

Table V. Risk factors for target organ damage.

Risk factor	B	s	β	t	p	95% CI
baPWV
SBP	4.64	0.75	0.5	6.21	< 0.001	3.16–6.11
Age	15.91	3.91	0.3	4.07	< 0.001	8.19–23.64
TC	50.19	13.46	0.24	3.73	< 0.001	23.60–76.79
BMI	−4.11	1.98	−0.17	−2.07	0.04	(−8.02)–(−0.20)
cfPWV
BMI	4.25	1.22	0.29	3.49	0.001	1.84–6.65
LDL-C	25.26	10.20	0.21	2.48	0.015	5.09–45.43
RWT
Age	0.00	0.00	−0.18	−2.29	0.02	(−0.01)–0.00
LVM
BMI	2.29	0.35	0.37	6.51	< 0.001	1.60–2.99
Age	4.60	0.68	0.34	6.73	< 0.001	3.25–5.95
Gender	−12.05	3.28	−0.17	−3.67	< 0.001	(−18.53)–(−5.56)
SBP	0.003	0.13	0.21	3.57	< 0.001	0.21–0.74
Physical activity	0.00	0.00	0.12	2.68	0.008	0–0.01
LVMI
BMI	0.67	0.10	0.57	6.67	< 0.01	0.47–0.87
HDL-C	5.08	1.58	0.22	3.21	0.002	1.96–8.21
TG	1.67	0.95	0.12	1.76	0.08	0.21–3.55
SBP	0.10	0.03	0.23	2.85	0.005	0.03–0.17
Age	−0.44	0.19	−0.17	−2.33	0.021	(−0.82)–(−0.07)
cIMT
BMI	0.00	0.00	0.397	5.788	< 0.001	0.001–0.003
Heart rate	0.00	0.00	−0.257	−3.758	< 0.001	(−0.0001)–0.000
HbA1c	0.01	0.00	0.162	2.367	0.019	0.001–0.015
hs-CRP
Sleep time	−2.02	0.44	−0.4	−4.57	< 0.001	(−2.90)–(−1.15)
Age	−0.49	0.18	−0.24	−2.77	0.006	(−0.84)–(−0.14)
mA1b/Cr
DBP	1.23	0.59	0.17	2.09	0.039	0.07–2.40
Gender	31.53	13.61	0.18	2.32	0.022	4.65–58.41
HbA1c	83.20	29.33	0.58	2.84	0.005	25.26–141.14
FPG	−30.09	13.66	−0.44	−2.2	0.029	(−57.08)–(−3.11)

baPWV, brachial–ankle PWV; cfPWV, carotid–femoral PWV; RWT, relative wall thickness; LVM, left ventricular mass; LVMI, left ventricular mass index; cIMT, carotid artery intima–media thickness; hs-CRP, high-sensitivity C-reactive protein; mA1b/Cr, microalbuminuria/creatinine; SBP, systolic blood pressure; TC, total cholesterol; BMI, body mass index; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; Hb_A1c, glycosylated hemoglobin; DBP, diastolic blood pressure; FPG, fasting plasma glucose; CI, confidence interval.

Figure 1. Effects of blood pressure on cardiovascular target organ damage. Normotensive as control; black triangles represent non-sustained hypertension; white circle represent sustained hypertension; black line represents 95% confidence interval (CI). OR, odds ratio; cfPWV, carotid–femoral pulse-wave velocity; LVM, ventricular mass index; cIMT, carotid intima–media thickness; hs-CRP, high-sensitivity C-reactive protein.