BACKGROUND: Nighttime blood pressure (BP) and systolic BP variability on ambulatory blood pressure monitoring (ABPM) have been strongly associated with target-organ damage in hypertensive adults. The clinical relevance of these variables in children with hypertension remains under-studied. METHODS: The study group included children aged 5-18 years old referred to the outpatient nephrology clinic for an elevated casual BP who underwent an ABPM and echocardiography (ECHO) study and did not have secondary hypertension. The interpretation of ABPM parameters and left ventricular mass index (LVMI) was based on normative references. RESULTS: Seventy-two children fulfilled the inclusion criteria. The association of various potential predictors including age, BMI z-score, casual BP z-score and ABPM parameters (BP z-score, BP load, nocturnal dipping and BP variability- within-subject standard deviation (SD) of BP) with LVMI was analyzed. On adjusted regression analysis, nighttime systolic BP load [standardized regression coefficient (β) 0.23; p < 0.05] and daytime systolic BP variability (β 0.37; p < 0.05) had significant association with LVMI. CONCLUSIONS: In children with primary hypertension, nighttime systolic BP load and daytime systolic BP variability had a stronger association with LVMI than casual BP and other ABPM parameters. Future longitudinal studies are needed to establish the causality among these variables.
BACKGROUND: Nighttime blood pressure (BP) and systolic BP variability on ambulatory blood pressure monitoring (ABPM) have been strongly associated with target-organ damage in hypertensive adults. The clinical relevance of these variables in children with hypertension remains under-studied. METHODS: The study group included children aged 5-18 years old referred to the outpatient nephrology clinic for an elevated casual BP who underwent an ABPM and echocardiography (ECHO) study and did not have secondary hypertension. The interpretation of ABPM parameters and left ventricular mass index (LVMI) was based on normative references. RESULTS: Seventy-two children fulfilled the inclusion criteria. The association of various potential predictors including age, BMI z-score, casual BP z-score and ABPM parameters (BP z-score, BP load, nocturnal dipping and BP variability- within-subject standard deviation (SD) of BP) with LVMI was analyzed. On adjusted regression analysis, nighttime systolic BP load [standardized regression coefficient (β) 0.23; p < 0.05] and daytime systolic BP variability (β 0.37; p < 0.05) had significant association with LVMI. CONCLUSIONS: In children with primary hypertension, nighttime systolic BP load and daytime systolic BP variability had a stronger association with LVMI than casual BP and other ABPM parameters. Future longitudinal studies are needed to establish the causality among these variables.
Authors: Elaine Ku; Charles E McCulloch; Bradley A Warady; Susan L Furth; Barbara A Grimes; Mark M Mitsnefes Journal: Clin J Am Soc Nephrol Date: 2018-02-13 Impact factor: 8.237
Authors: Gilad Hamdani; Edward J Nehus; Coral D Hanevold; Judith Sebestyen Van Sickle; Robert Woroniecki; Scott E Wenderfer; David K Hooper; Douglas Blowey; Amy Wilson; Bradley A Warady; Mark M Mitsnefes Journal: Transplantation Date: 2017-01 Impact factor: 4.939
Authors: Gilad Hamdani; Joseph T Flynn; Stephen Daniels; Bonita Falkner; Coral Hanevold; Julie Ingelfinger; Marc B Lande; Lisa J Martin; Kevin E Meyers; Mark Mitsnefes; Bernard Rosner; Joshua Samuels; Elaine M Urbina Journal: Blood Press Monit Date: 2019-02 Impact factor: 1.444