Aortic stiffness in patients with childhood essential hypertension: Is obesity a risk factor or not?

Background

Hypertension (HTN) is a global health problem with a rising prevalence that affects both children and adults.

Objectives

We aim to assess aortic stiffness in children with essential HTN using echocardiography and evaluate the parameters that influence the development of aortic stiffness.

Methods

Included in the prospective study were patients who were newly diagnosed with essential HTN and who were admitted to the Pediatric Nephrology and Pediatric Cardiology outpatient clinics of Adiyaman University between June 1 and December 31, 2022. All patient groups underwent 24-hour ambulatory blood pressure monitoring (ABPM) for a definitive diagnosis of essential HTN. The echocardiographic examinations of all participants were carried out by the same pediatric cardiologist. Aortic stiffness parameters and Epicardial Adipose Tissue (EAT) thickness were measured by routine echocardiography. Patients under the age of 18 years were included in the study. Demographic data, serum biochemical parameters, echocardiography findings, and 24-hour ABPM data were noted.

Results

A total of 76 children were enrolled in the study, including 31 patients (9 female; 22 male) and 45 controls (14 female; 31 male). The control and patient groups had similar overall sex and age distributions. Systolic and diastolic blood pressure and pulse pressure were higher in the hypertensive group than in the control group (p < 0.01). Considering the effects of obesity and HTN, three groups were formed. A significant reduction in aortic distensibility was noted in the non-obese hypertensive group when compared to the control group (p = 0.047).

Conclusion

Non-obese hypertensive children showed significantly reduced aortic distensibility than the control group, suggesting that the etiology of HTN in the non-obese hypertensive group may involve mechanisms beyond obesity-related factors. Seeking preventative care is more common in obese patients than non-obese patients.