Hypertension-Related End Organ Damage Evident in Teenagers
The best balance between false-positive and false-negative for left ventricular hypertrophy (LVH) was seen at the 90th percentile for SBP.
Healthday News — Some adolescents, including those at normal or mid-risk level based on their systolic blood pressure (SBP), have target organ damage, according to a study presented at the American Heart Association's Council on Hypertension 2017 Scientific Sessions, held from Sept. 14 to 17 in San Francisco.
Elaine M. Urbina, MD, from Cincinnati Children's Hospital, and colleagues examined blood pressure and measured organ damage in 180 teenagers (aged 14 to 17 years). Participants were classified as normal (104 teenagers; SBP <80th percentile), mid-risk (38 teenagers; SBP 80 to <90th percentile), or high-risk (38 teenagers; SBP >90th percentile).
The researchers found that the mean BP increased across risk groups (109/74 for normal, 126/82 for mid-risk, and 135/87 mm Hg for high-risk).
Left ventricular mass and pulse-wave velocity also increased across groups. After adjustment for covariants, including demographics, age, body mass index, and heart rate, percentile SBP remained a significant determinant of target organ damage. The best balance between false-positive and false-negative for left ventricular hypertrophy (LVH) was seen at the 90th percentile for SBP. Even at the 80th percentile, 8% of LVH cases were missed; 16% had LVH at SBP <95th percentile.
"Some adolescents may have organ damage related to blood pressure and are not targeted for therapy," Urbina said in a statement. "Imaging of the heart may be useful in youth in the high-normal range of blood pressure to determine how aggressive therapy should be."
Teens also at risk for organ damage from high blood pressure [press release]. Dallas, Texas: American Heart Association. Published September 17, 2017. Accessed September 26, 2017.