Hypertension: An Important But Reversible Cause of Systolic Dysfunction in a Cohort of Pediatric Patients

Alicia M. Kamsheh, Kevin E. Meyers, Robert A. Palermo, Lezhou Wu, Danielle S. Burstein, Jonathan B. Edelson, Kimberly Y. Lin, Katsuhide Maeda, Joseph W. Rossano, Carol A. Wittlieb-Weber, Matthew J. O’Connor

Research output: Contribution to journalArticlepeer-review


Cardiac dysfunction due to hypertension (CDHTN) in pediatrics is not well described. We aimed to describe the presentation and outcomes of pediatric CDHTN and identify clinical features associated with resolution of dysfunction. A single-center retrospective cohort study of patients ≤ 21 years with CDHTN from January 2005–September 2020 was performed. Patients with systolic dysfunction without another cause, blood pressure > 95th percentile, and physician judgment that dysfunction was secondary to hypertension were included. Demographics, clinical characteristics, echocardiographic findings, and outcomes were examined using Fisher’s exact and Mann–Whitney U tests. Multiple correspondence analysis was used to explore the relationship of resolution of dysfunction to clinical features. Thirty-four patients were analyzed at a median age of 10.9 (IQR 0.3–16.9) years. Patients were divided into groups < 1 year (n = 12) and ≥ 1 year (n = 22). Causes of hypertension were varied by age, with renovascular disease most common in infants (42%) and medical renal disease most common in older patients (77%). Echocardiography demonstrated mild LV dilation (median LV end-diastolic z-score 2.6) and mild LV hypertrophy (median LV mass z-score 2.4). Most patients (81%) had resolution of dysfunction, particularly infants (92%). One patient died and one patient was listed for heart transplant. None required mechanical circulatory support (MCS). No clinical features were statistically associated with resolution of dysfunction. Hypertension is an important but reversible cause of systolic dysfunction in children. Patients are likely to recover with low mortality and low utilization of MCS or transplantation. Further studies are needed to confirm features associated with resolution of dysfunction.

Original languageEnglish
Pages (from-to)331-339
Number of pages9
JournalPediatric Cardiology
Issue number2
StatePublished - Feb 2024


  • Dysfunction
  • Hypertension
  • Hypertensive
  • Hypertensive cardiomyopathy
  • Systolic


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