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J Pediatr. 2013 Jan;162(1):94-100. doi: 10.1016/j.jpeds.2012.06.009. Epub 2012 Jul 19.

High risk blood pressure and obesity increase the risk for left ventricular hypertrophy in African-American adolescents.

Author information

1
Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. Bonita.Falkner@jefferson.edu

Abstract

OBJECTIVE:

To examine the relative effects of high blood pressure (HBP) and obesity on left ventricular mass (LVM) among African-American adolescents; and if metabolic or inflammatory factors contribute to LVM.

STUDY DESIGN:

Using a 2 × 2 design, African-American adolescents were stratified by body mass index percentile (body mass index <95th percentile = non-obese; ≥ 95th percentile = obese) and average blood pressure (BP) (normal BP <120/80 mm Hg; HBP ≥ 120/80). Glucose, insulin, insulin resistance, lipids, and inflammatory cytokines were measured. From echocardiography measures of LVM, calculated LVM index (LVMI) ≥ 95th percentile defined left ventricular hypertrophy (LVH).

RESULTS:

Data included 301 adolescents (48% female), mean age 16.2 years, 51% obese, and 29% HBP. LVMI was highest among adolescents with both obesity and HBP. The multiplicative interaction of obesity and HBP on LVH was not significant (OR = 2.35, P = .20) but the independent additive associations of obesity and HBP with log-odds of LVH were significant; obesity OR = 3.26, P < .001; HBP OR = 2.92, P < .001. Metabolic and inflammatory risk factors were associated with obesity, but had no independent association with LVMI. Compared with those with average systolic BP (SBP) <75th percentile, adolescents with SBP from the 75th percentile to 90th percentile had higher LVMI (33.2 vs 38.7 g/m(2.7), P < .001) and greater LVH (18% vs 43%, P < .001), independent of obesity.

CONCLUSIONS:

Prevalence of LVH is highest among African-American adolescents with average BP ≥ 120/80 mm Hg and obesity. There also is an independent association of LVMI with BP, beginning at the 75th SBP percentile.

PMID:
22817908
PMCID:
PMC3480988
DOI:
10.1016/j.jpeds.2012.06.009
[Indexed for MEDLINE]
Free PMC Article
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