Terezie Suláková1, Janusz Feber. 1. Department of Pediatrics, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic. terezie.sulakova@fno.cz
Abstract
BACKGROUND: The diagnosis of hypertension (HTN)/normotension (NT) on ambulatory blood pressure monitoring (ABPM) is usually based on systolic (SBP) or diastolic blood pressure (DBP). The goal of this study was to analyze whether inclusion of mean arterial pressure (MAP) improves the detection of HTN on ABPM. METHODS: We retrospectively studied ABPM records in 229 children (116 boys, median age = 15.3 years) who were referred for evaluation of HTN. A diagnosis of HTN was made if: (A) MAP or SBP or DBP was ≥ 1.65 SDS (95th percentile); (B) SBP or DBP was ≥ 1.65 SDS (95th percentile), during 24-h or daytime or night-time in both definitions. RESULTS: Using definition A, 46/229 patients had HTN compared to definition B by which only 37/229 patients had HTN (p = 0.001). The level of agreement between the two definitions was very good (kappa = 0.86 ± 0.04), however nine patients (19.5 %) were missed by not using MAP in the definition of HTN. These nine patients had only mild HTN with a median Z score of 1.69. CONCLUSIONS: The inclusion of MAP in the definition of ambulatory HTN significantly increased the number of hypertensive patients. MAP may be very helpful in detecting mild HTN in patients with normal/borderline SBP and DBP.
BACKGROUND: The diagnosis of hypertension (HTN)/normotension (NT) on ambulatory blood pressure monitoring (ABPM) is usually based on systolic (SBP) or diastolic blood pressure (DBP). The goal of this study was to analyze whether inclusion of mean arterial pressure (MAP) improves the detection of HTN on ABPM. METHODS: We retrospectively studied ABPM records in 229 children (116 boys, median age = 15.3 years) who were referred for evaluation of HTN. A diagnosis of HTN was made if: (A) MAP or SBP or DBP was ≥ 1.65 SDS (95th percentile); (B) SBP or DBP was ≥ 1.65 SDS (95th percentile), during 24-h or daytime or night-time in both definitions. RESULTS: Using definition A, 46/229 patients had HTN compared to definition B by which only 37/229 patients had HTN (p = 0.001). The level of agreement between the two definitions was very good (kappa = 0.86 ± 0.04), however nine patients (19.5 %) were missed by not using MAP in the definition of HTN. These nine patients had only mild HTN with a median Z score of 1.69. CONCLUSIONS: The inclusion of MAP in the definition of ambulatory HTN significantly increased the number of hypertensivepatients. MAP may be very helpful in detecting mild HTN in patients with normal/borderline SBP and DBP.
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Elke Wühl; Antonella Trivelli; Stefano Picca; Mieczyslaw Litwin; Amira Peco-Antic; Aleksandra Zurowska; Sara Testa; Augustina Jankauskiene; Sevinc Emre; Alberto Caldas-Afonso; Ali Anarat; Patrick Niaudet; Sevgi Mir; Aysin Bakkaloglu; Barbara Enke; Giovanni Montini; Ann-Margret Wingen; Peter Sallay; Nikola Jeck; Ulla Berg; Salim Caliskan; Simone Wygoda; Katharina Hohbach-Hohenfellner; Jiri Dusek; Tomasz Urasinski; Klaus Arbeiter; Thomas Neuhaus; Jutta Gellermann; Dorota Drozdz; Michel Fischbach; Kristina Möller; Marianne Wigger; Licia Peruzzi; Otto Mehls; Franz Schaefer Journal: N Engl J Med Date: 2009-10-22 Impact factor: 91.245