The hemodynamic aspects of parameters in arterial hypertension in children with overweight and history of cardiovascular diseases

Abstract

Arterial hypertension, in the context of excess weight, represents an important health problem, and research in the field proves the importance of aggravated family history for the occurrence, evolution and severity of arterial hypertension, as well as suggests that hypertension increases the prevalence of cardiac structural changes. The purpose of the study: evaluation of hemodynamic parameters, electrocardiographic and echocardiographic changes in hypertensive children with excess weight and a family history aggravated by cardiovascular diseases. Material and methods: the study included 75 hypertensive patients, with an average age of 14.7 years, overweight and obese, being divided into two research groups according to the presence of family history (FH) aggravated by cardiovascular diseases: group I-35 hypertensive children, overweight, obese, without aggravated family history; group II-40 hypertensive, overweight and obese children with a family history aggravated by cardiovascular pathology in first-generation relatives up to 45 years old. To assess hemodynamic parameters, all children were examined using ECG, EcoCG and AMBP/24 hours. Results. Through the electrocardiographic method, with statistical significance, signs of hyperfunction of the LV myocardium were determined in 21 (52,5%) patients from the AH, overweight, obese, FH+ and only in 9 (25,7%) from the AH, overweight, obese FH- (p<0.05). Hypertrophy of the LV myocardium was found in 5 (12,5%) cases from the group of children with hypertension, overweight, obese, FH+ and in 4 (11,4%) cases from those with hypertension, overweight, obese FH- (p>0,05). The echocardiographic parameters did not show statistically significant differences, however the values of TSD (30.029±0,973 mm), TDD (47.600± 0,803 mm), IVS (9.629±0.232 mm), PWLV (10.390± 0.800 mm) were increased in the group. of hypertensive, overweight, obese, FH+ children compared to the group of hypertensive, overweight, obese FH- children, and the protocol parameters at AMBP/24 hours were also higher in hypertensive, overweight, obese, FH+ children (p>0,05). Conclusions: arterial hypertension and obesity play an important role in establishing the morphofunctional changes of the heart, and the family history aggravated by cardiovascular diseases is a predictive factor in the evolution of LVH. Electrocardiographic left ventricular hypertrophy was revealed in 12.5% of cases from the group of children with hypertension, overweight, obese, FH+ and 11.4% of cases from those with hypertension, overweight, obese FH- (p>0.05), and echocardiographic parameters of the compartment left heart were more increased in children with aggravated family history.