Prediction of left ventricular mass in youth with family histories of essential hypertension

To determine predictors of left ventricular mass (LVM) and hypertrophy (LVH), 56 black and 30 white normotensive healthy youths (mean age 12.6 ± 2.3 years at initial visit) were studied twice, 2.5 years apart. During the initial visit, anthropometric variables and hemodynamics were measured at rest and before, during, and after 4 physical and behavioral stressors. 2-D directed M-mode echocardiography was performed to derive LVM. Hierarchical multiple regression analyses indicated that follow-up LVM was predicted by initial LVM, weight, height (ht), and gender (males > females; total model R² = 0.77, P < 0.0001). Predictors of LVM/ht^2.7 were initial LVM/ht^2.7, weight, ethnicity (blacks > whites), and the aggregate index of blood pressure reactivity (total model R² = 0.66, P < 0.0001). Youth with LVH at follow-up were taller, heavier, and exhibited greater blood pressure reactivity at initial evaluation. These findings are important since interventional strategies can be developed that target obesity and exaggerated reactivity to stress.