12 - Nocturnal Hypertension and Left Ventricular Hypertrophy in Adolescents

A retrospective analysis was conducted on 250 individuals 13-20 years of age with suspected hypertension between 2019 and 2021 who had ABPMs performed and an echocardiogram performed within 6 months of the ABPM. Abnormal ABPM was defined by American Heart Association 2022 guidelines as systolic or diastolic HTN present or attenuated nocturnal dipping (< 10%). Patients were categorized into four ABPM phenotypes: all normal BP, abnormal wake BP only, abnormal wake and sleep BP, and abnormal sleep BP only. Echocardiographic LVH was dichotomized as left ventricular mass index (LVMI) below versus greater than or equal to 51 g/m^2.7 per American Academy of Pediatrics 2017 guidelines. Analyses were by chi-square comparing normal vs abnormal LVMI and multivariable logistic regression.


Results: Of the 250 patients, 183 (73%) were male, 74 (30%) were non-Hispanic white, 47 (19%) were non-Hispanic black, and 114 (46%) were Hispanic. Overall, 128 (51%) of the ABPMs were normal. Echocardiograms were present in 236.  Of those 236, LVH was present in 29 (12%). Table 1 compares BP phenotypes between LVH versus no LVH, showing no significant differences between the groups.  Those with elevated nighttime systolic BP approached significance. Logistic regression modeling found LVH was only associated with obesity (OR 7.904 (1.71, 35.22) p=0.007) and with no BP parameter.

Conclusion(s): In this multiethnic pediatric cohort, sleep BP category did not reach statistically significant association with LVH, while obesity did. Given the known correlation between obesity and HTN, previous associations may need to further disentangle prospective associations between obesity versus BP and deleterious cardiac remodeling.