Research Horizons


Blood Pressure Level for Predicting Left Ventricular Hypertrophy Risk in Teens Should be Lower

High blood pressure (hypertension) can lead to a variety of adverse cardiovascular events including left ventricular hypertrophy (LVH), an enlargement of the walls in the heart’s main pumping chamber. Among adolescents, hypertension-induced LVH can increase the risk of future cardiovascular events, such as stroke or a heart attack.

Historically, hypertension has been defined in children as blood pressure exceeding the 95th percentile of the population. However, the actual blood pressure linked with increased left ventricular mass (LVM) and indicators of heart damage (LVH) in youth remains unknown.

Until specific risk levels are known, a study recently published in Hypertension by Elaine Urbina MD, MS, and her team at the Heart Institute suggests taking a more conservative approach to the historic threshold.

The team studied adolescent blood pressure data and classified individuals into low-risk, mid-risk or high-risk categories. Results showed that with an increase in average blood pressure, left ventricular mass and size, LVM and LVH, both increased. This demonstrates a significant link between hypertension and heart structural changes in adolescents.

Those with high-risk blood pressure (categorized in this study as the 90th percentile or above) had the greatest increase in LVM and LVH.

Rather than the current 95th percentile threshold, co-authors say this study indicates that the 90th percentile may be more clinically appropriate when predicting adverse cardiovascular events in adolescents. Using the lower threshold to target interventions may ultimately lead to greater improvements in heart health across the lifespan.

—This post was authored by Emma Agnew, PhD, Research Fellow, Heart Institute at Cincinnati Children’s. Find Dr. Agnew on Instagram @emmascience and Twitter @DrEJAgnew


Publication Information
Original title: Association of Blood Pressure Level With Left Ventricular Mass in Adolescents
Published in: Hypertension
Publish date: July 22, 2019
Read the study

Research By

Elaine Urbina, MD, MS
Director, Preventive Cardiology
Dr. Urbina studies pediatric high blood pressure, cholesterol, diet and exercise to prevent adult heart disease.