Zhonghua Er Ke Za Zhi. 2026 Aug 2;64(8):905-910. doi: 10.3760/cma.j.cn112140-20251119-01039.
ABSTRACT
Objective: To investigate the risk factors of vascular function damage in children with primary hypertension and establish a risk prediction model. Methods: In this retrospective case-control study, a total of 117 children aged 6-17 years with primary hypertension, hospitalized at Capital Center for Children's Health, Capital Medical University, between February 2024 and October 2025 were included. Flow mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) were used as indicators of vascular function impairment. The children were divided into a vascular function damage group and a normal vascular function group according to the presence or absence of vascular function damage. Independent samples t-test or Mann-Whitney U test was used for intergroup comparison of measurement data, χ2 test or Fisher's exact test was used for enumeration data. Differences in clinical, laboratory and vascular function-related indicators were compared between the two groups. Multivariate Logistic regression was employed to identify independent risk factors, based on which a nomogram was constructed. The predictive performance was verified by the receiver operating characteristic (ROC) curve. Results: Among 117 hypertensive children, there were 92 (78.6%) males and 25 (21.4%) females, with the age of (13.0±2.1) years at admission. There was 58 (49.6%) with vascular function damage. The body fat percentage, 24 h mean systolic blood pressure, daytime systolic blood pressure, nocturnal systolic blood pressure, low-density lipoprotein, total cholesterol, triglycerides, homocysteine, folic acid, fasting insulin, uric acid and cfPWV levels in the vascular function damage group (58 cases) were significantly higher than those in the normal group (59 cases), while the FMD level in the vascular function damage group was significantly lower than that in the normal group (all P<0.05). Multivariate Logistic regression identified that: nocturnal systolic blood pressure (SBP) (OR=1.06, 95%CI 1.01-1.10, P=0.019), serum low-density lipoprotein (LDL) (OR=5.51,95%CI 2.41-12.58,P<0.001), and homocysteine (OR=1.11,95%CI 1.03-1.19,P=0.005) were independent risk factors for vascular function damage. A nomogram prediction model was constructed accordingly, and the Logistic regression equation was: Logit(P)=-10.73+0.05×nocturnal systolic blood pressure+1.71×low-density lipoprotein+0.10×homocysteine. The ROC curve for the nomogram showed an area under curve of 0.82 (95%CI 0.74-0.89, P<0.001), with a sensitivity of 0.76 and a specificity of 0.71. Conclusion: Nocturnal systolic blood pressure, low-density lipoprotein and homocysteine are independent risk factors for vascular function damage in children with primary hypertension.
PMID:42527134 | DOI:10.3760/cma.j.cn112140-20251119-01039