MetS risk higher in children with primary hypertension

Children with hypertension, particularly those with primary hypertension, are vulnerable to developing metabolic syndrome (MetS), reveals a study.

A total of 420 patients aged 10‒18 years with hypertension confirmed by ambulatory blood pressure monitoring (ABPM) were included in this study.

All participants underwent anthropometric evaluation, office BP and ABPM measurements, biochemical testing including uric acid, and assessment of hypertension-mediated organ damage: left ventricular (LV) mass index, carotid intime-media thickness (cIMT), and pulse wave velocity.

Of the patients, 14.5 percent had MetS, including 18.3 percent of children 10‒15 years of age and 9.4 percent of those aged 16‒18 years. Children with primary vs secondary hypertension were more likely to have MetS (17.7 percent vs 5.5 percent; p=0.003).

Patients with MetS had higher triglyceride and low-density lipoprotein cholesterol levels, slightly higher fasting plasma glucose (p=0.061), and lower high-density lipoprotein cholesterol level (p<0.001) than non-MetS participants. Uric acid levels were also higher in primary than secondary hypertension (5.8 vs 5.2 mg/dl; p<0.001) and in MetS vs non-MetS patients (6.3 vs 5.5 mg/dl; p<0.001).

Furthermore, MetS correlated with greater cIMT standard deviation score (1.26 vs 0.92; p=0.012) and more frequent LV hypertrophy (42 percent vs 29 percent; p=0.08). These findings persisted across primary and secondary hypertension subgroups.

Notably, the addition of uric acid to the MetS definition improved the prediction of LV hypertrophy, increasing agreement from κ=0.086 to 0.190.