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Can office blood pressure readings predict masked hypertension?

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Abstract

Background

Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP).

Methods/Results

We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26–50th percentile and casual BP in 51–90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2–7 %, and of abnormal BP load was 6–16 %.

Conclusions

These data suggest that masked hypertension is unlikely if the casual BP is found to be in the low normal range.

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Acknowledgments

Data in this manuscript were collected by the Chronic Kidney Disease in Children prospective cohort study (CKiD). The CKiD is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from, the National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01 DK82194, U01-DK-66143, U01-DK-66174, and U01-DK-66116). The CKID website is located at http://www.statepi.jhsph.edu/ckid.

Financial Disclosure

There are no conflicts of interest to disclose.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue ML 7022, Cincinnati, OH, 45229, USA

    Mark M Mitsnefes

  2. Johns Hopkins University School of Public Health, Baltimore, MD, USA

    Chris Pierce

  3. Seattle Children’s Hospital, Seattle, WA, USA

    Joseph Flynn

  4. University of Texas, Houston, TX, USA

    Joshua Samuels

  5. British Columbia University, Vancouver, BC, Canada

    Janis Dionne

  6. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan Furth

  7. Section of Pediatric Nephrology, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA

    Bradley Warady

Authors
  1. Mark M Mitsnefes
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  2. Chris Pierce
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  3. Joseph Flynn
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  4. Joshua Samuels
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  5. Janis Dionne
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  6. Susan Furth
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  7. Bradley Warady
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For the CKiD study group

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Correspondence to Mark M Mitsnefes.

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Mitsnefes, M.M., Pierce, C., Flynn, J. et al. Can office blood pressure readings predict masked hypertension?. Pediatr Nephrol 31, 163–166 (2016). https://doi.org/10.1007/s00467-015-3212-5

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  • DOI: https://doi.org/10.1007/s00467-015-3212-5

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