Łukasz Obrycki1, Janusz Feber2, Grażyna Brzezińska3, Mieczysław Litwin4. 1. Department of Nephrology, Kidney Transplantation and Hypertension, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland. 2. Division of Nephrology, Department of Pediatrics, The Children's Hospital of Eastern Ontario, Ottawa, Canada. 3. Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland. 4. Department of Nephrology, Kidney Transplantation and Hypertension, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland. m.litwin@ipczd.pl.
Abstract
BACKGROUND: The clinical significance of isolated systolic hypertension with normal central blood pressure known as spurious hypertension (sHT) in adolescents and its evolution over time is not known. METHODS: The aim of this study was to analyze changes in office, ambulatory blood pressure (ABPM), central systolic blood pressure (cSBP), hemodynamic parameters, and target organ damage (TOD) over a 1-year follow-up in a group of non-obese children with sHT. RESULTS: Of 294 patients referred for primary hypertension, 138 patients (31 girls; 22%) had hypertension confirmed by ABPM. 48/138 (35%) patients (7 girls; 15%) were diagnosed with sHT (elevated office and ambulatory systolic BP, but normal cSBP); 43 of them (6 girls; 14%) were followed for 12 ± 3 months during non-pharmacological therapy. At baseline 7 (16%) patients had borderline values of cIMT or LVMi indicating mild TOD. After 12 months, 10/43 (3 girls; 23%) patients developed sustained HT (elevated office, ambulatory BP and cSBP), 11/43 (1 girl; 26%) maintained sHT, and 22/43 (2 girls; 51%) evolved to white coat hypertension or normotension. The cSBP values increased in 27 patients (4 girls; 63%), but the group average remained in the normal range. Prevalence of TOD did not change during observation. The multivariate regression analysis showed that the only predictor of cSBP change over time was a change in serum uric acid level. CONCLUSIONS: In conclusion, after 1 year of non-pharmacological treatment, 23% of adolescents with sHT developed sustained hypertension, with the main predictor of cSBP change being the change in serum uric acid.
BACKGROUND: The clinical significance of isolated systolic hypertension with normal central blood pressure known as spurious hypertension (sHT) in adolescents and its evolution over time is not known. METHODS: The aim of this study was to analyze changes in office, ambulatory blood pressure (ABPM), central systolic blood pressure (cSBP), hemodynamic parameters, and target organ damage (TOD) over a 1-year follow-up in a group of non-obese children with sHT. RESULTS: Of 294 patients referred for primary hypertension, 138 patients (31 girls; 22%) had hypertension confirmed by ABPM. 48/138 (35%) patients (7 girls; 15%) were diagnosed with sHT (elevated office and ambulatory systolic BP, but normal cSBP); 43 of them (6 girls; 14%) were followed for 12 ± 3 months during non-pharmacological therapy. At baseline 7 (16%) patients had borderline values of cIMT or LVMi indicating mild TOD. After 12 months, 10/43 (3 girls; 23%) patients developed sustained HT (elevated office, ambulatory BP and cSBP), 11/43 (1 girl; 26%) maintained sHT, and 22/43 (2 girls; 51%) evolved to white coat hypertension or normotension. The cSBP values increased in 27 patients (4 girls; 63%), but the group average remained in the normal range. Prevalence of TOD did not change during observation. The multivariate regression analysis showed that the only predictor of cSBP change over time was a change in serum uric acid level. CONCLUSIONS: In conclusion, after 1 year of non-pharmacological treatment, 23% of adolescents with sHT developed sustained hypertension, with the main predictor of cSBP change being the change in serum uric acid.
Authors: Joanna B Trojanek; Anna Niemirska; Jacek Michałkiewicz; Mieczysław Litwin; Renata Grzywa; Aldona Wierzbicka; Łukasz Obrycki; Zbigniew Kułaga; Mieczysław Szalecki Journal: J Hum Hypertens Date: 2019-03-29 Impact factor: 3.012
Authors: Anna Deja; Piotr Skrzypczyk; Magdalena Nowak; Małgorzata Wrońska; Michał Szyszka; Anna Ofiara; Justyna Lesiak-Kosmatka; Anna Stelmaszczyk-Emmel; Małgorzata Pańczyk-Tomaszewska Journal: Int J Environ Res Public Health Date: 2022-05-13 Impact factor: 4.614