Study Finds Evidence of Hypertension Risk Factors in Children as Young as 11
Published May 2020 | Hypertension
A novel study of hypertension in teens aged 11 to 19 years old has uncovered subclinical and metabolic changes at levels that might warrant intervention in childhood and adolescence to address risk factors that can lead to cardiovascular disease later in life.
Heart Institute researchers compared echocardiogram results for left ventricular strain and diastolic function—two precursors of heart failure in adults—in 346 pediatric subjects classified into low-, mid- and high-risk blood pressure levels.
Among the findings: Teens in the mid- and high-risk categories showed greater adiposity, lower HDL and higher glucose and insulin levels compared to teens in the low-risk group. They also showed significantly lower ejection fraction and peak global longitudinal strain indicating reduced systolic function and higher E/e’ ration indicating diastolic dysfunction.
“Previously, it was thought that high blood pressure-related cardiac damage took years to develop,” says preventive cardiology director Elaine Urbina, MD, MS. “This is one of the first studies to demonstrate reduced systolic and diastolic cardiac function at the higher range of blood pressure in otherwise healthy youth, even though the mean value is still within the normal range. Data suggests that appropriate early intervention, including diet, weight loss, and possibly medication to control BP, may prevent permanent damage that leads to heart failure in adulthood.”
Since the study was published, lead author and former cardiology fellow Andrew Tran, MD, and Urbina have presented study data at pediatric academic, hypertension, and nephrology conferences in the U.S., Poland and Italy.
A basic science arm of the same study led to a gene expression hypothesis that hypertension may lead to upregulation of hsa-miR-30e-5p, an RNA precursor, which in turn favors the upregulation of vasohibin (VASH-1), a protein coding gene. Follow-up research will explore the importance of VASH-1 in animal models and its role in progression of cardiac disease damage.
