Clinical Manifestation of Ambulatory Blood Pressure Monitoring in Children and Adolescent with Hypertension

ABSTRACT

BACKGROUND: The use of ambulatory blood pressure monitoring (ABPM) in childhood hypertension has been in great advance. ABPM has been able to detect significantly high blood pressure (BP) and also helpful for identifying white coat hypertension. METHODS: Between March 2007 and December 2009, we evaluated individuals aged from 7 to 19 years who were referred as high BP with ABPM, echocardiogram, and abdominal computerized tomography, calculation of body mass index (BMI) at Ajou University Hospital. ABPM was performed using the Tonoport V monitors and SpaceLab 90217 monitors. Seventy were evaluated with 55 boys and 5 girls. The mean age of them was 13.1 +/- 2.8 years (mean +/- standard deviation). RESULTS: Forty of seventy (57.1%) were diagnosed as hypertension in ABPM and 8 of 40 were diagnosed as secondary hypertension with underline diseases such as hyperthyroidism, chronic renal disease, Takayasu's arteritis, coarctation of aorta. The mean BMI in 40 was 24.8 +/- 4.72 kg/m2. Twenty-three of seventy (32.8%) were obese with higher prevalence than in general population. White coat hypertension was diagnosed in 30 of 70 (42.9%). CONCLUSIONS: ABPM could provide more detailed data including mean values of BP, load, and night dip in assessment of children's BP. According to increasing children's obesity, use of ABPM was thought to be necessary for evaluation of their risk of hypertension and useful for diagnosis of masked hypertension and white coat hypertension. Further more study of ABPM in children and adolescents would be needed for absolute standards of ABPM.