Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening

Jonathan M. Sorof, Jennifer Turner, David S. Martin, Kathleen Garcia, Zsolt Garami, Andrei Alexandrov, Fiona Wan, Ronald J. Portman

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

To determine whether systematic differences exist between hypertensive children referred for evaluation by primary care providers and children identified through community-based screening, cardiovascular risk factors and surrogate markers of hypertensive injury were compared based on subject source (referral versus screening). Children referred to a hypertension clinic for persistently elevated blood pressure were compared with children identified as hypertensive during school screening of 5102 students in Houston public schools. M-mode echocardiography of the left ventricle was performed and subsequently reviewed by 2 independent sonographers blinded to identifying subject information. Subsets of subjects also underwent carotid artery ultrasound for measurement of intimal-medial thickness, overnight urine collections for microalbuminuria, and fasting serum cholesterol, triglycerides, and glucose. Ninety-seven total subjects (54 screening and 43 referral) met inclusion criteria and had technically adequate echocardiography performed. The prevalence of left ventricular hypertrophy (LVH) was 37%. Referral subjects demonstrated significantly greater left ventricular mass index (38.8 versus 34. 2 g/M2.7.; P<0.01) and a higher prevalence of LVH (49% versus 28%; P<0.05). Among subjects who underwent carotid ultrasound (n=75), carotid intimal-medial thickness was significantly higher in referral subjects (0.61 versus 0.57, P<0.05). When controlling for BMI z score, which was significantly higher in referral subjects, systematic differences by subject source did not persist. These findings suggest that hypertensive children who are predominantly overweight, independent of the manner in which patients come to medical attention, will manifest evidence of more severe cardiovascular disease assessed by surrogate markers such as left ventricular mass index or carotid artery intimal medial thickness.

Original languageEnglish (US)
Pages (from-to)214-218
Number of pages5
JournalHypertension
Volume43
Issue number2 I
DOIs
StatePublished - Feb 1 2004

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Tunica Intima
Referral and Consultation
Left Ventricular Hypertrophy
Carotid Arteries
Echocardiography
Biomarkers
Urine Specimen Collection
Heart Ventricles
Fasting
Primary Health Care
Triglycerides
Cardiovascular Diseases
Cholesterol
Students
Blood Pressure
Hypertension
Glucose
Wounds and Injuries
Serum

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening. / Sorof, Jonathan M.; Turner, Jennifer; Martin, David S.; Garcia, Kathleen; Garami, Zsolt; Alexandrov, Andrei; Wan, Fiona; Portman, Ronald J.

In: Hypertension, Vol. 43, No. 2 I, 01.02.2004, p. 214-218.

Research output: Contribution to journalArticle

Sorof, Jonathan M. ; Turner, Jennifer ; Martin, David S. ; Garcia, Kathleen ; Garami, Zsolt ; Alexandrov, Andrei ; Wan, Fiona ; Portman, Ronald J. / Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening. In: Hypertension. 2004 ; Vol. 43, No. 2 I. pp. 214-218.
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