[Ambulatory blood pressure monitoring in children and adolescents--our results].

Abstract

Unlabelled: Objective of the study was to present the results of ambulatory blood pressure monitoring (ABPM) in children and adolescents with hypertension diagnosed by primary care physician.

Methods: we retrospectively reviewed ABPM studies in 76 children. Mean patient age was 14.3 years (4-17 years); 53 boys (69.7%) and 23 girls (30.3%). Children were classified as having either primary or secondary hypertension following a standardised evaluation. According to ABPM data hypertension was defined as mean blood pressure greater than 95 th percentile for age, gender and height and/or blood pressure load (BP load) greater than 25 percent.

Results: In 16 (21.1%) children the ABPM studies were normal, leading to a diagnosis of "white coat hypertension" (WCH). Among 50 (65.8%) children with primary hypertension the most (20 or 40% children) had stage 3 hypertension. In secondary hypertension group 6 (60%) of children had stage 3 hypertension. Daytime and nocturnal systolic and diastolic blood pressure values were greater in patients with secondary hypertension compared with patients with primary hypertension.

Discussion: The oscillometric monitors for ABPM are generally preferred in children. The high percentage of stage 3 hypertension in both primary and secondary hypertension can be partly explained with normative values used witch were those recommended by consensus group such as the Second Task Force. Daytime and nocturnal systolic and diastolic blood pressure values greater in patients with secondary hypertension correspond to data in literature.

Conclusions: ABPM is important tool in the evaluation and management of childhood hypertension. A normotension in ABPM study will suggest WCH. According toABPM results it is possible to classify hypertension, to identify children who require more detailed evaluation and to asses the efficacy of antihypertensive treatment. The lack of consensus and generaly accepted normative data for pediatric population in ABPM interpretation require further investigation.