PEDIATRICS Vol. 111 No. 1 January 2003, pp. 61-66
Carotid Artery Intimal-Medial Thickness and Left Ventricular Hypertrophy in Children With Elevated Blood Pressure
* Departments of Pediatrics
Neurology, University of Texas Medical School at Houston, Houston, Texas
--> Objectives. To determine the association between carotid artery intimal-medial thickness (cIMT) and left ventricular mass index (LVMI) in children with elevated blood pressure.
Methods. Study subjects (n = 32; mean age: 13.9 ± 2.7 years) were untreated new referrals to a pediatric hypertension clinic with confirmed elevated blood pressure. LVM was calculated from 2-dimensionally guided m-mode echocardiographic measurements of the left ventricle. LVMI was calculated as LVM (g)/height (m)2.7, and left ventricular hypertrophy (LVH) was defined as LVMI >95th percentile. Carotid artery duplex ultrasound was performed by protocol by experienced vascular sonographers who were unaware of the echocardiography results. The thickest IMT complex of the far wall of the distal common carotid artery was measured in longitudinal B-mode section using a high-resolution linear array of 8 MHz.
Results. The prevalence of LVH and increased cIMT was 41% and 28%, respectively. Subjects with increased cIMT had higher LVMI (46.8 g/m2.7 vs 31.4 g/m2.7) than those with normal cIMT. The LVH prevalence was 89% (8 of 9) among subjects with increased cIMT as compared with 22% (5 of 23) in subjects with normal cIMT. cIMT was positively correlated with body mass index (r = 0.43), interventricular septal thickness (r = 0.58), posterior wall thickness (r = 0.54), and LVMI (r = 0.54). cIMT and LVMI were positively associated after accounting for age, gender, and body mass index.
Conclusions. These findings raise the possibility that carotid duplex ultrasound, by indicating the presence of early arterial wall changes, may be useful for predicting other cardiovascular sequelae in hypertensive children.
Key Words: hypertension • child • echocardiography • left ventricular hypertrophy • carotid ultrasound • intimal-medial thickness
Abbreviations: LVM, left ventricular mass • LVH, left ventricular hypertrophy • cIMT, intimal-medial thickness of the carotid artery • LVMI, left ventricular mass index • CCA, common carotid artery • BMI, body mass index
Received for publication Apr 3, 2002; Accepted Jun 13, 2002.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  E. M. Urbina, R. V. Williams, B. S. Alpert, R. T. Collins, S. R. Daniels, L. Hayman, M. Jacobson, L. Mahoney, M. Mietus-Snyder, A. Rocchini, et al. Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association Hypertension, November 1, 2009; 54(5): 919 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Ataei, M. Hosseini, and M. Iranmanesh The Relationship of Body Mass Index and Blood Pressure in Iranian Children <7 Years Old J Trop Pediatr, October 1, 2009; 55(5): 313 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Giannini, T de Giorgis, A Scarinci, I Cataldo, M L Marcovecchio, F Chiarelli, and A Mohn Increased carotid intima-media thickness in pre-pubertal children with constitutional leanness and severe obesity: the speculative role of insulin sensitivity, oxidant status, and chronic inflammation Eur. J. Endocrinol., July 1, 2009; 161(1): 73 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Jadhav and J. F. Ndisang Heme Arginate Suppresses Cardiac Lesions and Hypertrophy in Deoxycorticosterone Acetate-Salt Hypertension Experimental Biology and Medicine, July 1, 2009; 234(7): 764 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Flynn Hypertension in the young: epidemiology, sequelae and therapy Nephrol. Dial. Transplant., February 1, 2009; 24(2): 370 - 375. [Full Text] [PDF]
|
|
|
|
 |
|
 A. M Franks, C. E O'Brien, C. D Stowe, T. G Wells, and S. F Gardner Candesartan Cilexetil Effectively Reduces Blood Pressure in Hypertensive Children Ann. Pharmacother., October 1, 2008; 42(10): 1388 - 1395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Urbina, B. Alpert, J. Flynn, L. Hayman, G. A. Harshfield, M. Jacobson, L. Mahoney, B. McCrindle, M. Mietus-Snyder, J. Steinberger, et al. Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research Hypertension, September 1, 2008; 52(3): 433 - 451. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Gidding Measuring Children's Blood Pressure Matters Circulation, June 24, 2008; 117(25): 3163 - 3164. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Velasquez-Mieyer, C. P. Neira, R. Nieto, and P. A. Cowan Review: Obesity and cardiometabolic syndrome in children Therapeutic Advances in Cardiovascular Disease, October 1, 2007; 1(1): 61 - 81. [Abstract] [PDF]
|
|
|
|
|
|
C. Hadtstein and F. Schaefer What adult nephrologists should know about childhood blood pressure Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2119 - 2123. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Beauloye, F. Zech, H. Tran Thi Mong, P. Clapuyt, M. Maes, and S. M. Brichard Determinants of Early Atherosclerosis in Obese Children and Adolescents J. Clin. Endocrinol. Metab., August 1, 2007; 92(8): 3025 - 3032. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Hernandez-Diaz, L. J. Van Marter, M. M. Werler, C. Louik, and A. A. Mitchell Risk Factors for Persistent Pulmonary Hypertension of the Newborn Pediatrics, August 1, 2007; 120(2): e272 - e282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Groner, M. Joshi, and J. A. Bauer Pediatric Precursors of Adult Cardiovascular Disease: Noninvasive Assessment of Early Vascular Changes in Children and Adolescents Pediatrics, October 1, 2006; 118(4): 1683 - 1691. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Gale, B. Jiang, S. M. Robinson, K. M. Godfrey, C. M. Law, and C. N. Martyn Maternal Diet During Pregnancy and Carotid Intima-Media Thickness in Children Arterioscler Thromb Vasc Biol, August 1, 2006; 26(8): 1877 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Flynn What Is the Significance of Increased Carotid Intima Media Thickness in Hypertensive Adolescents? Hypertension, July 1, 2006; 48(1): 23 - 24. [Full Text] [PDF]
|
|
|
|
|
|
M. B. Lande, N. L. Carson, J. Roy, and C. C. Meagher Effects of Childhood Primary Hypertension on Carotid Intima Media Thickness: A Matched Controlled Study Hypertension, July 1, 2006; 48(1): 40 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Srinivasan, L. Myers, and G. S. Berenson Changes in Metabolic Syndrome Variables Since Childhood in Prehypertensive and Hypertensive Subjects: The Bogalusa Heart Study Hypertension, July 1, 2006; 48(1): 33 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pinto, R. Roldan, and T. P. Sollecito Hypertension in children: an overview. J Dent Educ., April 1, 2006; 70(4): 434 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Abdelghaffar, M. El Amir, A. El Hadidi, and F. El Mougi Carotid Intima-Media Thickness: An Index for Subclinical Atherosclerosis in Type 1 Diabetes J Trop Pediatr, February 1, 2006; 52(1): 39 - 45. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Iannuzzi, M. R. Licenziati, C. Acampora, V. Salvatore, L. Auriemma, M. L. Romano, S. Panico, P. Rubba, and M. Trevisan Increased Carotid Intima-Media Thickness and Stiffness in Obese Children Diabetes Care, October 1, 2004; 27(10): 2506 - 2508. [Full Text] [PDF]
|
|
|
|
|
|
National High Blood Pressure Education Program Wor The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents Pediatrics, August 1, 2004; 114(2/S2): 555 - 576. [Full Text] [PDF]
|
|
|
|
|
|
A. H. Slyper What Vascular Ultrasound Testing Has Revealed about Pediatric Atherogenesis, and a Potential Clinical Role for Ultrasound in Pediatric Risk Assessment J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3089 - 3095. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. J. Mancini, B. Dahlof, and J. Diez Surrogate Markers for Cardiovascular Disease: Structural Markers Circulation, June 29, 2004; 109(25_suppl_1): IV-22 - IV-30. [Full Text] [PDF]
|
|
|
|
|
|
S. Ten and N. Maclaren Insulin Resistance Syndrome in Children J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2526 - 2539. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Sorof, J. Turner, D. S. Martin, K. Garcia, Z. Garami, A. V. Alexandrov, F. Wan, and R. J. Portman Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening Hypertension, February 1, 2004; 43(2): 214 - 218. [Abstract] [Full Text] [PDF]
|
|
