Background

Isolated nocturnal hypertension (INH) is associated with increased prevalence of left ventricular hypertrophy (LVH) and cardiovascular morbidity and mortality in adult patients. Unlike in adults, data illustrating the possible association between INH and cardiac target organ damage is lacking in children. This study aimed to investigate whether INH is associated with increased left ventricular mass index (LVMI) and LVH in children.

Methods

Retrospective data from all untreated children with confirmed ambulatory hypertension (HT) in our center was reviewed. Ambulatory blood pressure monitoring (ABPM) and echocardiography were performed concurrently. Ambulatory normotensive children served as controls. LVH was defined as LVMI ≥ 95th percentile.

Results

There were 102 ABPM studies; of these, 79 children had renal HT, and 23 had primary HT. Median age of children was 13.2 years (3.8–18.9). Nineteen children had INH, 9 children had isolated daytime HT, 54 had daytime and nighttime HT, and 20 were normotensive. The LVMI adjusted for age (patient’s LVMI/95th percentile of the LVMI) was significantly higher in children with INH than in normotensive children (0.83 ± 0.03 vs. 0.74 ± 0.03, p = 0.03). Left ventricular hypertrophy was present in 11% of children with INH; this was not significantly higher than in normotensive children (0%, p = 0.23).

Conclusions

This study investigated the association between INH and cardiac structure in children with primary and renal HT and showed children with INH had higher LVMI adjusted for age than normotensive children and children with INH had similar LVMI adjusted for age to children with isolated daytime HT.

中文翻译：

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单纯性夜间高血压与儿童左心室质量指数增加有关

背景

单纯性夜间高血压 (INH) 与成年患者左心室肥厚 (LVH) 和心血管发病率和死亡率的增加有关。与成人不同，儿童缺乏说明 INH 与心脏靶器官损害之间可能关联的数据。本研究旨在调查 INH 是否与儿童左心室质量指数 (LVMI) 和 LVH 增加有关。

方法

回顾了我们中心所有确诊为动态高血压 (HT) 的未治疗儿童的回顾性数据。同时进行动态血压监测（ABPM）和超声心动图。非卧床血压正常的儿童作为对照。LVH 定义为 LVMI ≥ 95%。

结果

有 102 项 ABPM 研究；其中，79 名儿童患有肾性 HT，23 名儿童患有原发性 HT。儿童的中位年龄为 13.2 岁（3.8-18.9）。19 名儿童患有 INH，9 名儿童患有孤立的日间 HT，54 名儿童患有日间和夜间 HT，20 名儿童血压正常。INH 患儿的年龄调整后的 LVMI（患者的 LVMI/LVMI 的第 95 个百分位数）显着高于血压正常的儿童（0.83 ± 0.03 对 0.74 ± 0.03，p = 0.03）。11% 的 INH 儿童存在左心室肥大；这并不明显高于血压正常的儿童（0%，p = 0.23）。

结论

本研究调查了原发性和肾性 HT 患儿 INH 与心脏结构之间的关系，发现 INH 患儿的年龄校正后 LVMI 高于血压正常儿童，INH 患儿的年龄校正后 LVMI 与单纯日间 HT 患儿相似。