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Comparison of ambulatory blood pressure and Task Force criteria to identify pediatric hypertension

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Abstract

The aim of this study was to assess the level of agreement between central European ambulatory blood pressure monitoring (ABPM) and American Task Force (TF) criteria when applied to blood pressure (BP) measurements collected by ABPM to evaluate patients with hypertension. In 169 patients, we applied both sets of criteria and calculated mean daytime and nighttime BP and daytime BP loads. The frequency of hypertension for daytime systolic BP was significantly higher when TF criteria were used (p ≤ 0.001). However, the frequency of hypertension for nighttime systolic BP was significantly increased when ABPM criteria were applied (p ≤ 0.01). Therefore, with daytime ABPM measurements, hypertension was overdiagnosed with TF criteria, while nighttime hypertension was underdiagnosed using TF criteria. In contrast with previous reports, 40% of our patients with essential hypertension showed absence of nighttime dipping, regardless of the criteria used. The number of hypertensive patients was significantly higher using ABPM compared to TF criteria when patients with BP load ≥50% were evaluated (p ≤ 0.01). Therefore, current recommendations for ABPM use in children such as to define white coat hypertension or as a screening tool to differentiate between primary and secondary hypertension need to be validated using yet to be produced normative ABPM criteria in American children.

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References

  1. Avner ED, Harmon WE, Niaudet P (2004) Pediatric nephrology, 5th edn. Lippincott Williams and Wilkins, Philadelphia, PA, pp 1125–1145

    Google Scholar 

  2. Sinaiko AR (1993) Pharmacologic management of childhood hypertension. Pediatr Clin North Am 40:195–212

    Article  CAS  Google Scholar 

  3. Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ (2004) Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 113:475–482

    Article  Google Scholar 

  4. 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 114:555–579

    Article  Google Scholar 

  5. Mule G, Nardi E, Andronico G, Cottone S, Raspanti F, Piazza G, Volpe V, Ferrara D, Cerasola G (2001) Relationships between 24 h blood pressure load and target organ damage in patients with mild-to-moderate essential hypertension. Blood Press Monit 6:115–123

    Article  CAS  Google Scholar 

  6. Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, McClory S, Den Hond E, McCormack P, Staessen JA, O’Brien E (2005) Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 46:156–161

    Article  CAS  Google Scholar 

  7. Tsioufis C, Stefanadis C, Goumas G, Pitsavos C, Toutouzas P (1999) Relation of ambulatory blood pressure load with left ventricular geometry in untreated patients with mild-to-moderate hypertension. J Hum Hypertens 13:677–682

    Article  CAS  Google Scholar 

  8. Grossman E, Alster Y, Shemesh J, Nussinovitch N, Rosenthal T (1994) Left ventricular mass in hypertension: correlation with casual, exercise and ambulatory blood pressure. J Hum Hypertens 8:741–746

    CAS  PubMed  Google Scholar 

  9. Khan IA, Gajaria M, Stephens D, Balfe JW (2000) Ambulatory blood pressure monitoring in children: a large center’s experience. Pediatr Nephrol 14:802–805

    Article  CAS  Google Scholar 

  10. Flynn JT (2000) Impact of ambulatory blood pressure monitoring on the management of hypertension in children. Blood Press Monit 5:211–216

    Article  CAS  Google Scholar 

  11. Sorof JM, Portman RJ (2000) Ambulatory blood pressure monitoring in the pediatric patient. J Pediatr 136:578–586

    Article  CAS  Google Scholar 

  12. Sorof JM, Portman RJ (2000) White coat hypertension in children with elevated casual blood pressure. J Pediatr 137:493–497

    Article  CAS  Google Scholar 

  13. Sorof JM, Portman RJ (2001) Ambulatory blood pressure measurements. Curr Opin Pediatr 13:133–137

    Article  CAS  Google Scholar 

  14. Flynn JT, Alderman MH (2005) Characteristics of children with primary hypertension seen at a referral center. Pediatr Nephrol 20:961–966

    Article  Google Scholar 

  15. Flynn JT (2002) Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics 110:89–93

    Article  Google Scholar 

  16. Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908

    Article  CAS  Google Scholar 

  17. Matsuoka S, Kawamura K, Honda M, Awazu M (2002) White coat effect and white coat hypertension in pediatric patients. Pediatr Nephrol 17:950–953

    Article  Google Scholar 

  18. Sorof JM (2000) White coat hypertension in children. Blood Press Monit 5:197–202

    Article  CAS  Google Scholar 

  19. Soergel M, Kirschtein 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

    Article  CAS  Google Scholar 

  20. Seeman T, Palyzova D, Dusek J, Janda J (2005) Reduced nocturnal blood pressure dip and sustained nighttime hypertension are specific markers of secondary hypertension. J Pediatr 147:366–371

    Article  Google Scholar 

  21. Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1997 National Center for Health Statistics version. Pediatrics 109:45–60

    Article  Google Scholar 

  22. Lurbe E, Sorof JM, Daniels SR (2004) Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 144:7–16

    Article  Google Scholar 

  23. Reichert H, Lindinger A, Frey O, Mortzeck J, Kiefer J, Busch C, Hoffmann W (1995) Ambulatory blood pressure monitoring in healthy schoolchildren. Pediatr Nephrol 9:282–286

    Article  CAS  Google Scholar 

  24. White WB, Larocca GM (2003) Improving the utility of the nocturnal hypertension definition by using absolute sleep blood pressure rather than the “dipping” proportion. Am J Cardiol 92:1439–1441

    Article  Google Scholar 

  25. White WB (1989) Assessment of daily blood pressure load as a determinant of cardiac function in patients with mild to moderate hypertension. Am Heart J 118:782–795

    Article  CAS  Google Scholar 

  26. 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

    Article  CAS  Google Scholar 

  27. Park MK, Menard SW, Schoolfield J (2005) Oscillometric blood pressure standards for children. Pediatr Cardiol 26:601–607

    Article  CAS  Google Scholar 

  28. Park MK, Menard SW, Yuan C (2001) Comparison of auscultatory and oscillometric blood pressures. Arch Pediatr Adolesc Med 155:50–53

    Article  CAS  Google Scholar 

  29. De Man SA, André JL, Bachmann H, Grobbee DE, Ibsen KK, Laaser U, Lippert P, Hofman A (1991) Blood pressure in childhood: pooled findings of six European studies. J Hypertens 9:109–114

    Article  Google Scholar 

  30. Grupo Cooperativo Español para el Estudio de los Factores de Riesgo Cardiovascular en la Infancia y la Adolescencia (1995) Estudio RICARDIN II: valores de referencia. An Esp Pediatr 43:11–17

    Google Scholar 

  31. Dimsdale JE, Heeren MM (1998) How reliable is nighttime blood pressure dipping? Am J Hypertens 11:606–609

    Article  CAS  Google Scholar 

  32. Nehal US, Ingelfinger JR (2002) Pediatric hypertension: recent literature. Curr Opin Pediatr 14:189–196

    Article  Google Scholar 

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Acknowledgments

We would like to thank Dr. Richard Neiberger for his helpful reviews and criticism of this article, as well as Ann Shoemaker, LPN for her technical assistance with the ABPM device.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, College of Medicine, University of Florida, P.O. Box 100296, Gainesville, FL, 32610, USA

    Leila N. Díaz & Eduardo H. Garin

Authors
  1. Leila N. Díaz
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  2. Eduardo H. Garin
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Correspondence to Eduardo H. Garin.

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Díaz, L.N., Garin, E.H. Comparison of ambulatory blood pressure and Task Force criteria to identify pediatric hypertension. Pediatr Nephrol 22, 554–558 (2007). https://doi.org/10.1007/s00467-006-0372-3

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  • DOI: https://doi.org/10.1007/s00467-006-0372-3

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