Discovery May Help Prevent Heart Disease In Children and Adolescents
CINCINNATI -- A new discovery by a physician at Children's Hospital Medical Center of Cincinnati may help prevent heart disease in children and adolescents in the United States who have hypertension -- high blood pressure.
In a study to be presented Monday, Nov. 13, at the annual meeting of the American Heart Association in New Orleans, Stephen Daniels, MD, PhD, a cardiologist at Children's Hospital Medical Center of Cincinnati, has found that an easily detectable, and possibly preventable, enlargement in the heart of children with hypertension may predict their risk of future cardiovascular disease.
"An enlargement of the left atrium (an upper chamber of the heart) is common in children and adolescents with hypertension," says Dr. Daniels. "This may indicate a subtle form of dysfunction of the heart and increased risk for future cardiovascular disease. Children and adolescents with hypertension should be evaluated using echocardiography to determine left atrial size as well as the mass of the left ventricle."
In the study, Dr. Daniels' colleagues at Children's Hospital Medical Center of Cincinnati performed echocardiography on 112 children and adolescents with hypertension. Left atrial size was above the 95th percentile in half of them. Height, weight, body mass index, age and blood pressure were also recorded.
Dr. Daniels found that obesity, systolic blood pressure elevation (the "higher" of the two measures of blood pressure) and an enlargement of the heart's left ventricle help determine whether there is increased left atrial size.
"We have known that enlargement and thickening of the left ventricle, leading to increased mass of the left ventricle, is common in children and adolescents with hypertension," says Dr. Daniels. "The fact that these same children also have increased left atrial size suggests that because the left ventricle is thick it may not be filling with blood as efficiently as it should after each contraction. This results in an 'upstream' effect on the left atrium.
"Problems with the left ventricle filling, also called diastolic dysfunction, may be the first step in a process that ultimately leads to problems with the heart's ability to squeeze and heart failure," adds Dr. Daniels. "Detection of this early sign, left atrial enlargement, may allow us to intervene earlier and prevent future problems. Weight loss and control of blood pressure may be useful in preventing the adverse cardiac effects of hypertension."
Nearly 700,000 American children between the ages of 10 and 18 have hypertension, which tends to run in families but also can be the result of an underlying disease. When underlying disease causes hypertension, it is known as secondary hypertension. But many children have high blood pressure for unknown reasons, and this is called primary hypertension. Obesity is believed to be an important factor in the development of primary hypertension for children and adults.
Medical evidence indicates that primary hypertension in adults begins in childhood. The American Heart Association recommends yearly blood pressure measurements for all children, starting at age 3 with well-child care.
Contact Information
Jim Feuer (
jfeuer@cchmc.org), 513-636-4656
