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Endothelial function in children with white-coat hypertension

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Abstract

Several studies have demonstrated endothelial dysfunction in patients with essential hypertension. However, the presence of endothelial dysfunction in children with white-coat hypertension has not been studied. We evaluated the endothelial function in children with white-coat hypertension and essential hypertension using a novel method based on the assessment of flow-mediated dilation (FMD). Study involved 106 children: 30 white-coat hypertensives (age 16.3 ± 1.3 years, mean ± SD), 30 essential hypertensives (age 16.4 ± 1.3 years), and 46 healthy controls (age 16.2 ± 1.4 years). Ultrasound scans of the right brachial artery were performed using Prosound F75 Aloka system during protocol: baseline (1 min), forearm ischemia (5 min), and post-occlusion phase (3 min). FMD (%) was expressed as a change of the arterial diameter from baseline to maximum post-occlusion value and the values < 5% were considered as deficient FMD. We found significantly lower FMD in both essential and white-coat hypertension compared to control group (p < 0.05 for both) with no significant difference between the hypertensive groups. Deficient FMD was found in both hypertensive groups, but not in the control group. The occurence of deficient FMD was significantly higher in both essential and white-coat hypertensives compared to controls (p < 0.01 for both) with no significant difference between the hypertensive groups. Our findings of endothelial dysfunction indicated by impaired FMD in pediatric patients with white-coat hypertension could help to elucidate the mechanisms of the increased cardiovascular risk that could be similar as found in essential hypertension; therefore, white-coat hypertension should not be considered a benign phenomenon.

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Acknowledgements

This research received Financial Grant VEGA 1/0087/14 and VEGA 1/0044/18, Slovak Republic, and was supported by the project “Biomedical Center Martin” ITMS code: 26220220187; the project is co-financed from EU sources.

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Authors and Affiliations

  1. Pediatric Cardiology Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Alexander Jurko Jr.

  2. Clinic of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 03601, Martin, Slovak Republic

    Tomas Jurko

  3. Catholic University in Ruzomberok, Faculty of Health Care, Ruzomberok, Slovak Republic

    Milan Minarik

  4. Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Michal Mestanik, Andrea Mestanikova, Vladimir Micieta, Zuzana Visnovcova & Ingrid Tonhajzerova

  5. Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic

    Michal Mestanik, Andrea Mestanikova, Vladimir Micieta, Zuzana Visnovcova & Ingrid Tonhajzerova

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  1. Alexander Jurko Jr.
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Correspondence to Tomas Jurko.

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The study was approved by the Ethics Committee of Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Oral and written informed consent was obtained from all individual participants included in the study.

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Jurko, A., Jurko, T., Minarik, M. et al. Endothelial function in children with white-coat hypertension. Heart Vessels 33, 657–663 (2018). https://doi.org/10.1007/s00380-017-1107-z

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