Endothelial Dysfunction, Pediatric Hypertension, Primary Hypertension
Conditions
Keywords
Pediatric Hypertension, Childhood Hypertension, Primary Hypertension, Endothelial Extracellular Vesicles, Endothelial Dysfunction, Endothelial Activation, Biomarkers, Microvascular Function, Laser Doppler Flowmetry, Cardiovascular Risk
Brief summary
Childhood hypertension is associated with early endothelial dysfunction and an increased risk of future cardiovascular disease. Endothelial extracellular vesicles (EEVs) have emerged as promising biomarkers of endothelial activation; however, their role in pediatric hypertension remains poorly understood. This observational case-control study aims to compare circulating EEV concentrations between normotensive children and children with newly diagnosed, untreated primary hypertension. The study will also investigate the associations between EEV levels, blood pressure, microvascular endothelial function assessed by laser Doppler flowmetry, and circulating biomarkers of endothelial activation. The findings may improve understanding of endothelial injury in pediatric hypertension and support the development of non-invasive biomarkers for early cardiovascular risk assessment.
Interventions
None listed
Sponsors
Josip Juraj Strossmayer University of Osijek
Osijek University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
6 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Children and adolescents aged 6-17 years. * Written informed consent from a parent or legal guardian and assent from the participant when appropriate. * Normotensive status or newly diagnosed, previously untreated primary hypertension according to current pediatric hypertension guidelines. * Ability to comply with study procedures.
Exclusion criteria
* Secondary hypertension. * Previous antihypertensive treatment. * Congenital heart disease or other significant cardiovascular disease. * Diabetes mellitus. * Chronic kidney disease. * Autoimmune or chronic inflammatory disease. * Acute infection at the time of enrollment. * Malignancy. * Use of medications known to affect endothelial function. * Inability to comply with study procedures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma endothelial extracellular vesicle concentration | Baseline | Concentration of circulating endothelial extracellular vesicles quantified by flow cytometry following size-exclusion chromatography isolation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-occlusive reactive hyperemia (PORH) | Baseline | Microvascular endothelium-dependent vasodilation assessed by laser Doppler flowmetry following 1-minute arterial occlusion. |
| Acetylcholine-induced vasodilation (AChID) | Baseline | Endothelium-dependent microvascular vasodilation assessed by acetylcholine iontophoresis and laser Doppler flowmetry. |
| Sodium nitroprusside-induced vasodilation (SNPID) | Baseline | Endothelium-independent microvascular vasodilation assessed by sodium nitroprusside iontophoresis and laser Doppler flowmetry. |
| VCAM-1 concentration | Baseline | Plasma vascular cell adhesion molecule-1 (VCAM-1) concentration measured as a marker of endothelial activation. |
| ICAM-1 concentration | Baseline | Plasma intercellular adhesion molecule-1 (ICAM-1) concentration measured as a marker of endothelial activation. |
| Endocan concentration | Baseline | Plasma endocan concentration measured as a marker of endothelial dysfunction. |
| von Willebrand factor (vWF) | Baseline | Plasma von Willebrand factor concentration measured as a marker of endothelial injury. |
| Matrix metalloproteinase-9 (MMP-9) | Baseline | Plasma MMP-9 concentration measured as a marker of vascular remodeling and endothelial dysfunction. |
Countries
Croatia
Contacts
CONTACTIvana Jukić, MD, PhD
CONTACTAna Stupin, MD, PhD
STUDY_CHAIRIvana Jukić, MD, PhD
Faculty of Medicine Osijek, Josip Juraj Strossmayer of Osijek
Outcome results
None listed