Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-25T17:21:17.765Z Has data issue: false hasContentIssue false
  • English
  • Français

Left ventricular mass of persistent masked hypertension in Hong Kong Chinese adolescents: a 4-year follow-up study

Published online by Cambridge University Press:  22 April 2018

Man-Ching Yam ,
Hung-Kwan So ,
Sit-Yee Kwok ,
Fung-Cheung Lo ,
Chi-Fung Mok ,
Chuk-Kwan Leung ,
Wai-Kwok Yip  and
Yn-Tz Sung
Man-Ching Yam
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
Hung-Kwan So*
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
Sit-Yee Kwok
Affiliation:
Department of Paediatric Cardiology, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China
Fung-Cheung Lo
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
Chi-Fung Mok
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
Chuk-Kwan Leung
Affiliation:
Department of Paediatrics, Kwong Wah Hospital, Hong Kong Special Administrative Region, Hong Kong, China
Wai-Kwok Yip
Affiliation:
Department of Medicine, St. Teresa’s Hospital, Hong Kong Special Administrative Region, Hong Kong, China
Yn-Tz Sung
Affiliation:
Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
*
Author for correspondence: Dr M.-C. Yam, Department of Paediatrics, Prince of Wales Hospital, 6/F, Lui Che Woo Clinical Sciences Building, Shatin, Hong Kong Special Administrative Region, PR China. Tel: 3505 2849; Fax: 2636 0020; E-mail: yammc@cuhk.edu.hk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

In our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort.

Design

Community prospective cohort study, follow-up of a case-control study in community.

Subjects

Patients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension.

Results

A total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (β=4.874, p<0.0001) and the patients with persistent masked hypertension (β=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (β=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (β=1.634, p=0.015).

Conclusions

Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.

Keywords

Left ventricular mass indexpersistent masked hypertensionambulatory blood pressureadolescents
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 6 , June 2018 , pp. 837 - 843
Check for updates
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Liu, JE, Roman, MJ, Pini, R, Schwartz, JE, Pickering, TG, Devereux, RB. Cardiac and arterial target organ damage in adults with elevated ambulatory and normal office blood pressure. Ann Intern Med 1999; 131: 564–572.Google Scholar
2. Sega, R, Trocino, G, Lanzarotti, A, et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: data from the general population (Pressione Arteriose Monitorate E Loro Associazioni [PAMELA] Study). Circulation 2001; 104: 1385–1392.CrossRefGoogle ScholarPubMed
3. Lurbe, E, Torro, I, Alvarez, V, et al. Prevalence, persistence, and clinical significance of masked hypertension in youth. Hypertension 2005; 45: 493–498.Google Scholar
4. McNiece, KL, Gupta-Malhotra, M, Samuels, J, et al. Left ventricular hypertrophy in hypertensive adolescents: analysis of risk by 2004 National High Blood Pressure Education Program Working Group staging criteria. Hypertension 2007; 50: 392–395.CrossRefGoogle Scholar
5. Stabouli, S, Kotsis, V, Toumanidis, S, Papamichael, C, Constantopoulos, A, Zakopoulos, N. White-coat and masked hypertension in children: association with target-organ damage. Pediatr Nephrol 2005; 20: 1151–1155.Google Scholar
6. Matsuoka, S, Awazu, M. Masked hypertension in children and young adults. Pediatr Nephrol 2004; 19: 651–654.Google Scholar
7. Pickering, TG, Davidson, K, Gerin, W, Schwartz, JE. Masked hypertension. Hypertension 2002; 40: 795–796.CrossRefGoogle ScholarPubMed
8. Verberk, WJ, de Leeuw, PW, Thien, T. Masked hypertension: where do we stand? Neth J Med 2006; 64: 58–60.Google Scholar
9. Yip, GW, Li, AM, So, HK, et al. Oscillometric 24-h ambulatory blood pressure reference values in Hong Kong Chinese children and adolescents. J Hypertens 2014; 32: 606–619.Google Scholar
10. Yip, GW, So, HK, Li, AM, Tomlinson, B, Wong, SN, Sung, RY. Validation of A&D TM-2430 upper-arm blood pressure monitor for ambulatory blood pressure monitoring in children and adolescents, according to the British Hypertension Society protocol. Blood Press Monit 2012; 17: 76–79.Google Scholar
11. Hui, SC. Criterion-related validity of a 0-10 scale physical activity rating in Chinese youth. Proceedings of the 2001 Asia-Pacific Rim Conference on Exercise and Sports Science: The New Perspective of Exercise & Sports Science for the Better Life in the 21st Century. Seoul, Korea: Seoul National University, 2001: 159.Google Scholar
12. Wong, SN, Tz Sung, RY, Leung, LC. Validation of three oscillometric blood pressure devices against auscultatory mercury sphygmomanometer in children. Blood Press Monit 2006; 11: 281–291.Google Scholar
13. Soergel, M, Kirschstein, M, Busch, C, et al. Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 1997; 130: 178–184.Google Scholar
14. Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.Google Scholar
15. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7: 79–108.Google Scholar
16. de Simone, G, Devereux, RB, Daniels, SR, Koren, MJ, Meyer, RA, Laragh, JH. Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 1995; 25: 1056–1062.Google Scholar
17. Matteucci, MC, Chinali, M, Rinelli, G, et al. Change in cardiac geometry and function in CKD children during strict BP control: a randomized study. Clin J Am Soc Nephrol 2013; 8: 203–210.Google Scholar
18. Verberk, WJ, Kessels, AG, de Leeuw, PW. Prevalence, causes, and consequences of masked hypertension: a meta-analysis. Am J Hypertens 2008; 21: 969–975.CrossRefGoogle ScholarPubMed
19. Mitsnefes, M, Flynn, J, Cohn, S, et al. Masked hypertension associates with left ventricular hypertrophy in children with CKD. J Am Soc Nephrol 2010; 21: 137–144.Google Scholar
20. de Simone, G, Devereux, RB, Daniels, SR, Meyer, RA. Gender differences in left ventricular growth. Hypertension 1995; 26: 979–983.Google Scholar
21. Wu, J, Wu, C, Fan, W, Zhou, J, Xu, L. Incidence and predictors of left ventricular remodeling among elderly Asian women: a community-based cohort study. BMC Geriatr 2017; 17: 21.Google ScholarPubMed
22. Buono, F, Spinelli, L, Giallauria, F, et al. Usefulness of satisfactory control of low-density lipoprotein cholesterol to predict left ventricular remodeling after a first ST-elevation myocardial infarction successfully reperfused. Am J Cardiol 2011; 107: 1772–1778.Google Scholar
23. de Simone, G, Daniels, SR, Devereux, RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992; 20: 1251–1260.Google Scholar
24. Li, X, Li, S, Ulusoy, E, Chen, W, Srinivasan, SR, Berenson, GS. Childhood adiposity as a predictor of cardiac mass in adulthood: the Bogalusa Heart Study. Circulation 2004; 110: 3488–3492.Google Scholar
25. Flynn, JT, Falkner, BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension 2017; 70: 683–686.CrossRefGoogle ScholarPubMed
26. de Simone, G, Daniels, SR, Kimball, TR, et al. Evaluation of concentric left ventricular geometry in humans: evidence for age-related systematic underestimation. Hypertension 2005; 45: 64–68.Google ScholarPubMed
27. Khoury, PR, Mitsnefes, M, Daniels, SR, Kimball, TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009; 22: 709–714.Google Scholar
28. Konstam, MA, Kramer, DG, Patel, AR, Maron, MS, Udelson, JE. Left ventricular remodeling in heart failure: current concepts in clinical significance and assessment. JACC Cardiovasc Imaging 2011; 4: 98–108.CrossRefGoogle ScholarPubMed
29. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18: 1440–1463.CrossRefGoogle Scholar