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- Title
Central blood pressure and measures of early vascular disease in children with ADPKD.
- Authors
Marlais, Matko; Rajalingam, Sreedevi; Gu, Haotian; Savis, Alexandra; Sinha, Manish D; Winyard, Paul JD
- Abstract
Background: There is growing recognition of hypertension in a significant proportion of children with ADPKD. In this study, we assessed blood pressure and cardiovascular status in children with ADPKD. Methods: A prospective two-centre observational study of children (< 18 years) with ADPKD was compared against age- and BMI-matched healthy controls. Children underwent peripheral BP (pBP) measured using an aneroid sphygmomanometer and auscultation, 24-h ambulatory BP monitoring (ABPM), non-invasive central BP (cBP) measurement, carotid-femoral pulse wave velocity (PWVcf) measured using applanation tonometry and measurement of indexed left ventricular mass (LVMI) using echocardiography. This study received independent ethical approval. Results: Forty-seven children with ADPKD and 49 healthy controls were recruited (median age 11 years vs. 12 years). Children with ADPKD had significantly higher systolic pBP (mean 112 ± 13.5 mmHg vs. 104 ± 11 mmHg, p < 0.001), higher systolic cBP (mean 97 ± 12.8 mmHg vs. 87 ± 9.8 mmHg, p < 0.001) and lower pulse pressure amplification ratio (1.59 ± 0.2 vs. 1.67 ± 0.1, p = 0.04) compared to healthy children. Thirty-five percent of children with ADPKD showed a lack of appropriate nocturnal dipping on 24-h ABPM. There was no difference in PWVcf between children with ADPKD and healthy children (mean 5.74 ± 1 m/s vs. 5.57 ± 0.9 m/s, p = 0.46). Those with ADPKD had a significantly higher LVMI (mean 30.4 ± 6.6 g/m2.7 vs. 26.2 ± 6.2 g/m2.7, p = 0.01). Conclusions: These data highlight the high prevalence of hypertension in children with ADPKD, also demonstrating early cardiovascular dysfunction with increased LVMI and reduced PP amplification despite preserved PWVcf, when compared with healthy peers. These early cardiovascular abnormalities are likely to be amenable to antihypertensive therapy, reinforcing the need for routine screening of children with ADPKD.
- Subjects
HYPERTENSION risk factors; AGE distribution; AMBULATORY blood pressure monitoring; AUSCULTATION; BLOOD pressure; CARDIOVASCULAR diseases risk factors; ECHOCARDIOGRAPHY; FEMORAL artery; HEALTH status indicators; HYPERTENSION; LONGITUDINAL method; SCIENTIFIC observation; PEDIATRICS; POLYCYSTIC kidney disease; RESEARCH ethics; SPHYGMOMANOMETERS; TONOMETRY; BODY mass index; DISEASE complications
- Publication
Pediatric Nephrology, 2019, Vol 34, Issue 10, p1791
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-019-04287-7