Assessment of target-organ damage in adolescent white-coat and sustained hypertensives

Aims and scope The aim of the present study was to assess whether a difference exists between intima-media thickness and the left ventricular mass index in healthy nonhypertensive, white-coat hypertensive and sustained hypertensive adolescents. Patients and methods Fifty-nine normotensive and 120 hypertensive adolescents were enrolled in our study. Hypertensive patients were classified into white-coat hypertension (WCH) and sustained hypertension groups based on 24-h ambulatory blood pressure measurements. Both normotensive and hypertensive individuals underwent routine laboratory tests, intima-media thickness measurements on the common carotid arteries and transthoracic echocardiography to measure the left ventricular mass index (LVMI). Results Intima-media thickness was higher both in WCH and sustained hypertension compared with healthy normotensive individuals (controls: 0.048 +/- 0.01 cm, WCH: 0.056 +/- 0.01 cm, sustained hypertension: 0.054 +/- 0.012 cm, both P<0.001 compared with controls, nonsignificant difference between the two hypertensive groups). There was no difference between the LVMI of control individuals and WCH (LVMI: 35.5 +/- 10.3g/m(2.7) and 37.7 +/- 11.2g/m(2.7) respectively, P=0.87). LVMI in sustained hypertension group (LVMI: 44.1 +/- 14.1g/m(2.7)) was significantly higher both compared with WCH (P<0.05), and healthy adolescents (P<0.001). Conclusion Target-organ damage develops in a stepwise fashion in adolescent hypertension. An increased intima-media thickness can be demonstrated not only in the sustained but also in the white-coat form of adolescent hypertension. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.