Abstract
Background: Subclinical target organ damage (TOD) has been common in hypertensive children, but there is limited data in the Chinese pediatric population. This study aimed to investigate the prevalence of subclinical TOD in the Chinese hypertensive children and adolescents.Methods: A cross-sectional study was performed in children and adolescents from four schools in Jinan, China between September 2012 and September 2014. The hypertensive status was confirmed based on elevated blood pressure across three different occasions. Those with hypertension were invited to participate in the evaluation of TOD (including heart, arteries, and kidney) and metabolic disorders. A total of 7,840 children and adolescents aged 6–17 years were recruited at baseline, of whom 373 were diagnosed as hypertensive after three separate visits, and 333 (89%) participated in evaluation of TOD.Results: Among 333 hypertensive children, 47.4% had elevated carotid intima-media thickness, 32.4% had left ventricular hypertrophy, 29.2% had dyslipidemia, 7.6% had liver dysfunction, and 4.1% had microalbuminuria. Cardiovascular damages were more prevalent in children aged 9–14 years than the other age groups (i.e., 6–8 and 15–17 years). Girls had higher proportion of microalbuminuria than boys (8.2 vs. 2.6%). No significant sex and age differences were observed for the prevalence of other TODs. Nearly all subclinical TODs were much more prevalent in hypertensive children who were overweight and obese than those with normal weight, except microalbuminuria.Conclusions: The subclinical TOD is prevalent in Chinese hypertensive children and adolescents. Effective measures should be taken to fight against subclinical TOD.
Highlights
With the obesity epidemic among youths, pediatric hypertension has been an alarming public health issue worldwide
333 of 373 school children (40 subjects were lost to follow-up) who were diagnosed with hypertension after repeated blood pressure (BP) measurements on three separate occasions participated for further evaluation of subclinical target organ damage (TOD)
The present study showed that subclinical TOD was common in Chinese hypertensive children and adolescents
Summary
With the obesity epidemic among youths, pediatric hypertension has been an alarming public health issue worldwide. Recent evidence suggests that pediatric hypertension is associated with the risk of subclinical target organ damage (TOD) in childhood [3]. Subclinical TOD manifests as injuries to several target organs, including the heart, arteries, and kidneys [3], which are risk factors for future cardiovascular events. Target Organ Damage in Hypertensive Children clearly showed that the major etiologies of adult cardiovascular disease originated from childhood [4]. If hypertension is controlled adequately, at least some of the subclinical TOD can be reversible [6]. Subclinical target organ damage (TOD) has been common in hypertensive children, but there is limited data in the Chinese pediatric population. This study aimed to investigate the prevalence of subclinical TOD in the Chinese hypertensive children and adolescents
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