{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:58:48Z","timestamp":1784818728540,"version":"3.55.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Primary hypertension in children is often characterized by high pulse pressure that could be attributable to increased ventricular ejection velocities and volumes and\/or increased arterial stiffness. The objective of this study was to examine the contributions of cardiac (ventricular ejection) and vascular (systemic vascular resistance, arterial stiffness, and pressure wave reflection) properties to primary hypertension in children and adolescents.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Children aged 8 to 18\u00a0years referred to a tertiary center for evaluation of hypertension and found to have primary hypertension (n=31) were compared with normotensive controls of similar age (n=50). Peripheral (brachial) and central (carotid) blood pressure waveforms and carotid\u2010femoral pulse wave velocity were measured by tonometry. Left ventricular outflow tract velocities and ejection volumes were measured by echocardiography. Wave separation and wave intensity analysis were used to assess pressure wave propagation. Increased mean arterial pressure in hypertensive children (90\u00b115 versus 76\u00b110\u00a0mmHg in hypertensive versus normotensive children; means\u00b1\n              <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n              ;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) was explained by increased heart rate and cardiac output (5.3\u00b12.0 versus 4.5\u00b11.2\u00a0L\/min adjusted for age and sex;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05) rather than increased systemic vascular resistance (18.0\u00b14.6 versus 19.3\u00b17.3\u00a0mmHg\/min\/mL;\n              <jats:italic>P<\/jats:italic>\n              =0.374). A more\u2010marked increase in pulsatility (peripheral pulse pressure 66\u00b121 versus 46\u00b112\u00a0mmHg;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) was explained by increased proximal aortic stiffness (pulse wave velocity, 3.3\u00b11.4 versus 2.5\u00b10.8\u00a0m\/s;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.005) and increased left ventricular ejection velocity (1.33\u00b10.24 versus 1.21\u00b10.18\u00a0m\/s;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiac overactivity characterized by increased heart rate and left ventricular ejection velocities and increased proximal pulse wave velocity may be the main cause of primary hypertension in children.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015097","type":"journal-article","created":{"date-parts":[[2020,6,6]],"date-time":"2020-06-06T09:43:38Z","timestamp":1591436618000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Hemodynamic Characterization of Primary Hypertension in Children and Adolescents"],"prefix":"10.1161","volume":"9","author":[{"given":"Ye","family":"Li","sequence":"first","affiliation":[{"name":"King's College London British Heart Foundation Centre London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Gu","sequence":"additional","affiliation":[{"name":"King's College London British Heart Foundation Centre London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish D.","family":"Sinha","sequence":"additional","affiliation":[{"name":"King's College London British Heart Foundation Centre London United Kingdom"},{"name":"Department of Pediatric Nephrology Evelina London Children's Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Chowienczyk","sequence":"additional","affiliation":[{"name":"King's College London British Heart Foundation Centre London United 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of the American Heart 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