Risk of Subclinical-Cardiovascular Outcomes in Children with Ambulatory Hypertension: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Several studies have shown associations between childhood hypertension (HTN) and subclinical-cardiovascular outcomes (SCOs) such as left ventricular hypertrophy (LVH), increased pulse wave velocity (PWV) and increased carotid intima media thickness (cIMT). These data support the effect of elevated blood pressure (BP) in children leading to cardiovascular risk in adults; however, the association is not consistent in all studies. In this review, we investigate the prevalence of SCOs in children with HTN, diagnosed by ambulatory blood pressure monitoring (ABPM). Methods: A systematic literature search was conducted on four electronic databases to include relevant full-length publications in English language, published abstracts and conference proceedings from Jan 1974 to Mar 2020. Article screening, data extraction and quality assessment were independently completed and verified by two reviewers. Primary outcomes included SCOs such as LVH, left ventricular mass index (LVMI), PWV and cIMT as per standard definitions. Meta-regression was done to adjust for the effect of body mass index (BMI) on LVMI. Results: Of 8996 studies, 38 were included for analysis. SCO indices were significantly greater in those with HTN than those with normotension (NTN). Mean difference between the HTN and NTN group was 0.03mm (95% CI: 0.01, 0.05) for cIMT, 0.42 m/sec (95% CI: 0.25-0.6) for PWV, and 5.02gm-2.7 (95% CI: 3.66-6.39) for LVMI. HTN group had 3-times higher odds of LVH (3.10 [95% CI: 1.65-5.82]). Meta regression showed that BMI had a significant influence on the mean differences in LVMI, with the mean difference in LVMI increasing by 0.81gm-2.7 (95% CI [0.42, 1.19], p < 0.001) per unit increase in BMI. Conclusions: Children with ambulatory HTN have a greater risk of SCOs. These findings emphasize the importance for children to have their BP within normal values.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.023 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.029 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".