Abstract
During the past several years, 24-hour (24-h) ambulatory blood pressure monitoring (ABPM) has become a useful tool for the diagnosis and management of children and adolescents with elevated blood pressure (BP). Some reports have also provided blood pressure nomograms for particular devices. However, there are very few reports of the use of this method in very young children. In our study we investigated the applicability of ABPM in 97 healthy infants and toddlers, aged from 2 to 30 months. A satisfactory ABPM profile was obtained in 86.6% of the children, with an average of 75.0% satisfactory BP recordings. The mean ± SD systolic and diastolic BP of healthy infants and toddlers was 99±12/62±12 mmHg during the daytime and 95±11/57±10 mmHg during the night, with no gender difference being observed. The 24-h mean ± SD systolic and diastolic BP, which may be a more appropriate measure of BP in this particular age group, was found to be 97±12/59±11 mmHg. We also confirmed the increase in systolic and diastolic BP with increased height (length). There was only a slight nocturnal decrease in BP. We conclude that this method is applicable for the assessment of blood pressure in very young children.
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References
Mancia G, Di Rienzo M, Parati G (1993) Ambulatory blood pressure monitoring: use in hypertension research and clinical practice. Hypertension 21:500–524
O’Brien E (2003) Ambulatory blood pressure monitoring in the management of hypertension. Heart 89:571–576
Simckes AM, Srivastava T, Alon US (2002) Ambulatory blood pressure monitoring in children and adolescents. Clin Pediatr 41:549–564
Morgenstern B (2002) Blood pressure, hypertension, and ambulatory blood pressure monitoring in children and adolescents. Am J Hypertens 15:64S–66S
Lurbe E, Redon J (2002) Reproducibility and validity of ambulatory blood pressure monitoring in children. Am J Hypertens 15:69S–73S
Sorof JM (2000) White coat hypertension in children. Blood Press Monit 5:197–202
Sorof JM, Poffenbarger T, Franco K, Portman R (2001) Evaluation of white coat hypertension in children: importance of the definitions of normal ambulatory blood pressure and the severity of casual hypertension. Am J Hypertens 14:855–860
Staessen JA, Byttebier G, Buntinx F, Celis H, O’Brien ET, Fagard R, for the Ambulatory blood pressure monitoring and treatment of hypertension investigators (1997) Antihypertensive treatment based on conventional or ambulatory blood pressure measurement. JAMA 278:1065–1072
Flynn JT (2000) Impact of ambulatory blood pressure monitoring on the management of hypertension in children. Blood Press Monit 5:211–216
Flynn JT (2002) Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics 110:89–93
Belsha CW (1999) ambulatory blood pressure monitoring and hypertensive target-organ damage in children. Blood Press Monit 4:161–164
Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908
Mansoor GA (2002) Ambulatory blood pressure monitoring in clinical trials in adults and children. Am J Hypertens 15:38S–42S
Soergl M, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W (1997) Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 130:178–184
Wühl E, Witte K, Soergl M, Mehls O, Schaefer F for the German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20:1995–2007
O’Sullivan JJ, Derrick G, Griggs P, Foxall R, Aitkin M, Wren C (1999) Ambulatory blood pressure in schoolchildren. Arch Dis Child 80:529–532
Lurbe E, Redon K, Liao Y, Tacons J, Cooper RS, Alvarez V (1994) Ambulatory blood pressure monitoring in normotensive children. Am J Hypertens 12:1417–1423
Gellermann J, Kraft S, Ehrich JHH (1997) Twenty-four-hour ambulatory blood pressure monitoring in young children. Pediatr Nephrol 11:707–710
Menghetti E, Cellitti R, Marsili D, Ferri M, Liberti A, Mucedola G (1997) Twenty-four-hour monitoring of blood pressure in premature and full-term new born babies. Eur Rev Med Pharmacol Sci 1:189–191
Mansoor GA, White WB (1997) Ambulatory blood pressure monitoring is a useful clinical tool in nephrology. Am J Kidney Dis 30:591–605
Lingens N, Dobos E, Lemmer B, Schaerer K (1996) Nocturnal blood pressure elevation in transplanted pediatric patients. Kidney Int 55: S175–S176
O’Brien E, Waeber B, Parati G, Staessen J, Myers MG (2001) Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 322:531–536
Goonasekera CDA, Dillon MJ (2000) Measurement and interpretation of blood pressure. Arch Dis Child 82:261–265
Lurbe E, Cremades B, Rodriguez C, Torro MI, Alvarez V, Redon J (1999) Factors related to quality of ambulatory blood pressure monitoring in a pediatric population. Am J Hypertens 12:929–933
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 144 [Suppl]:555–576
Task Force on blood pressure control in children (1987) Report of the Second Task Force on blood pressure control in children, 1987. Pediatrics 79:1–25
O’Brien E, Murphy J, Tyndall A, Atkins N, Mee F, McCarthy G, Staessen J, Cox J, O’Malley K (1991) Twenty-four-hour ambulatory blood pressure in men and women aged 17 to 80 years: the Allied Irish Bank Study. J Hypertens 9:355–360
Lurbe E, Redon J, Liao Y, Tacons J, Cooper RS, Alvarez V (1994) Ambulatory blood pressure monitoring in normotensive children. J Hypertens 12:1417–1423
Gosse P, Ansoborlo P, Lemetayer P, Clementy J (1996) Daytime and nighttime ambulatory blood pressure should be calculated over the true sleep/waking cycle and not over arbitrary periods. Am J Hypertens 9:269–272
Rosansky SJ, Menachery SJ, Wagner CM, Jackson K (1995) The effect of sleep intervals on analysis of 24-h ambulatory blood pressure data. Am J Hypertens 8:672–675
Bursztyn M, Mekler J, Wachtel N, Ben-Ishay D (1994) Siesta and ambulatory blood pressure monitoring. Am J Hypertens 7:217–221
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Varda, N.M., Gregorič, A. Twenty-four-hour ambulatory blood pressure monitoring in infants and toddlers. Pediatr Nephrol 20, 798–802 (2005). https://doi.org/10.1007/s00467-005-1857-1
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DOI: https://doi.org/10.1007/s00467-005-1857-1