Assessment of hypertension-mediated organ damage in children and adolescents with hypertension

Plain Language Summary Arterial hypertension is a serious condition that without treatment leads to increased cardiovascular risk and hypertension mediated organ damage (HMOD). HMOD includes damage of heart, vascular bed, kidneys, and central nervous system (CNS). Currently used methods of HMOD assessment include estimation of left ventricular mass index (LVMi) in echocardiography, electrocardiography, eye fundus examination, evaluation of kidney function and microalbuminuria. Other recommended, but not obligatory HMOD assessment methods include measurement of cIMT by ultrasonography and PWV. Recent studies indicate also cognitive impairment in hypertensive children measured in neurocognition tests and questionnaires. HMOD assessment in children and adolescents with arterial hypertension can support decision-making process concerning anti-HT treatment and monitoring of the long-term clinical outcomes. Effective antihypertensive treatment can lead to the regression of HMOD. Purpose: Arterial hypertension (HT) is a main, potentially reversible cardiovascular risk factor. Long lasting HT leads to hypertension mediated organ damage (HMOD) of heart, vascular bed, and kidneys. Assessment of HMOD is a standard diagnostic procedure in hypertensive adults and presence of HMOD is associated with increased cardiovascular risk. The assessment of main HMOD markers includes the assessment of left ventricular mass, carotid intima-media thickness, arterial stiffness expressed as pulse wave velocity, and assessment of microcirculation. In contrast to adults, proper interpretation of obtained results of HMOD must be adjusted to age and sex referential values. In the last two decades, numerous studies describing HMOD in children with hypertension have been published, including meta-analyses evaluating various methods of HMOD assessment. Here, we present current state of the art and discuss recommendations on HMOD evaluation in hypertensive children.