Hypertension-induced cardiac damage in children and adolescents.

Blood pressure elevation has numerous sequelae, including myocardial infarction, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease in adults. The impact of blood pressure elevation on target organs in children and adolescents has been less well studied. The most useful measure of cardiac effects of hypertension is the echocardiogram. Studies have now defined normal standards for left ventricular mass in young patients. In order to account for differences in body size, it is most appropriate to use left ventricular mass divided by the individual s height raised to a power of 2.7. It has been demonstrated that there is a high prevalence of left ventricular hypertrophy in adolescents with essential hypertension. Some adolescents develop severe hypertrophy and abnormal left ventricular geometry, even to a degree that would be associated with increased risk of cardiovascular disease morbidity in an adult patient. Further research is needed to better evaluate the regression of left ventricular hypertrophy. Clinicians should assess left ventricular mass index in the evaluation of pediatric patients with hypertension.