Ambulatory Blood Pressure Monitoring Methodology and Norms in Children

  • Elke WühlEmail author
Reference work entry


Over the last decades, ambulatory blood pressure monitoring (ABPM) has become a method of choice for the diagnosis and therapeutic monitoring of arterial hypertension in adult and pediatric patients. ABPM allows a more representative observation of blood pressure throughout day and night in a nonmedical environment compared to office blood pressure measurements as well as assessment of the circadian and even ultradian blood pressure variability. ABPM provides ability to detect white coat and masked hypertension, a better reproducibility of measurements and superior prediction of target organ damage. The use, interpretation, and limitations of ABPM in children and adolescents will be discussed in this chapter.


Hypertension Ambulatory blood pressure monitoring Children Pediatrics White coat hypertension Masked hypertension 



Ambulatory blood pressure monitoring


Blood pressure


Chronic kidney disease




Cardiovascular disease


Diastolic blood pressure




Mean arterial blood pressure


Masked hypertension


Office (or casual) blood pressure measurement


Systolic blood pressure


Target organ damage


White coat hypertension


  1. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension (2013) J Hypertens 31(10):1925–1938Google Scholar
  2. Amoore JN (2012) Oscillometric sphygmomanometers: a critical appraisal of current technology. Blood Press Monit 17(2):80–88PubMedGoogle Scholar
  3. Armstrong C, Joint National (2014) JNC8 guidelines for the management of hypertension in adults. Am Fam Physician 90(7):503–504PubMedGoogle Scholar
  4. Association for the Advancement of Medical Instrumentation/American National Standards Institute (2002) Manual, electronic or automated shygmomanometers. ANSI/AAMI, ArlingtonGoogle Scholar
  5. Bell CS, Poffenbarger TS, Samuels JA (2011) Ambulatory blood pressure status in children: comparing alternate limit sources. Pediatr Nephrol 26(12):2211–2217PubMedGoogle Scholar
  6. Brotman DJ, Davidson MB, Boumitri M, Vidt DG (2008) Impaired diurnal blood pressure variation and all-cause mortality. Am J Hypertens 21:92–97PubMedGoogle Scholar
  7. Brotons C, Singh P, Nishio T, Labarthe DR (1989) Blood pressure by age in childhood and adolescents: a review of 129 surveys worldwide. Int J Epidemiol 18(4):824–829PubMedGoogle Scholar
  8. Chaudhuri A, Sutherland SM, Begin B, Salsbery K, McCabe L, Potter D, Alexander SR, Wong CJ (2011) Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis. Clin J Am Soc Nephrol 6(4):870–876PubMedPubMedCentralGoogle Scholar
  9. Chobanian AV, Bakris GL, Black DL, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ (2003) The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 289(19):2560–2571Google Scholar
  10. Cole TJ, Green PJ (1992) Smoothing reference centile curves: the LMS method and penalized likelihood. StatMed 11:1305–1319Google Scholar
  11. Cuspidi C, Macca G, Sampieri L, Fusi V, Severgnini B, Michev I, Salerno M, Magrini F, Zanchetti A (2001) Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens 19:1539–1545PubMedGoogle Scholar
  12. Davis ML, Ferguson MA, Zachariah JP (2014) Clinical predictors and impact of ambulatory blood pressure monitoring in pediatric hypertension referrals. J Am Soc Hypertens 8(9):660–667PubMedPubMedCentralGoogle Scholar
  13. de Man SA, André JL, Bachmann HJ, Grobbee DE, Ibsen KK, Laaser U, Lippert P, Hofmann A (1991) Blood pressure in childhood: pooled findings of six European studies. J Hypertens 9:109–114PubMedGoogle Scholar
  14. Din-Dzietham R, Liu Y, Bielo MV, Shamsa F (2007) High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 116(13):1488–1496Google Scholar
  15. Eissa MA, Poffenbarger T, Portman RJ (2001) Comparison of the actigraph versus patients’ diary information in defining circadian time periods for analyzing ambulatory blood pressure monitoring data. Blood Pres Monit 6:21–25Google Scholar
  16. Ettinger LM, Freeman K, DiMartino-Nardi JR, Flynn JT (2005) Microalbuminuria and abnormal ambulatory blood pressure in adolescents with type 2 diabetes mellitus. J Pediatr 147:67–73Google Scholar
  17. Fan HQ, Li Y, Thijs L, et al. (2010) Prognostic value of isolated nocturnal hypertension on ambulatory measurement in 8711 individuals from 10 populations. J Hypertens 28(10):2036–2045PubMedGoogle Scholar
  18. Flechtner-Mors M, Neuhauser H, Reinehr T, Roost HP, Wiegand S, Siegfried W, Zwiauer K, Molz E, Holl RW, APV initiative, the BCNO (2015) Blood pressure in 57,915 pediatric patients who are overweight or obese based on five reference systems. Am J Cardiol 115(11):1587–1594PubMedGoogle Scholar
  19. Flynn JT (2002) Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics 110:89–93PubMedGoogle Scholar
  20. Flynn JT (2011) Ambulatory blood pressure monitoring in children: imperfect yet essential. Pediatr Nephrol 26(12):2089–2094PubMedGoogle Scholar
  21. Flynn JT, Daniels SR, Hayman LL et al. (2014) Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension 63(5):1116–1135PubMedPubMedCentralGoogle Scholar
  22. Flynn JT, Kaelber DC, Baker-Smith CM, et al (2017) Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 140(3):e20171904Google Scholar
  23. Furusawa EA, Filho UD, Junior DM, Koch VH (2011) Home and ambulatory blood pressure to identify white coat and masked hypertension in the pediatric patient. Am J Hypertens 24(8):893–897PubMedGoogle Scholar
  24. Gellermann J, Kraft S, Ehrich JH (1997) Twenty-four-hour ambulatory blood pressure monitoring in young children. Pediatr Nephrol 11(6):707–710PubMedGoogle Scholar
  25. Gimpel C, Wuhl E, Arbeiter K, Drozdz D, Trivelli A, Charbit M, Gellermann J, Dusek J, Jankauskiene A, Emre S, Schaefer F, ESCAPE Trial Group (2009) Superior consistency of ambulatory blood pressure monitoring in children: implications for clinical trials. J Hypertens 27(8):1568–1574PubMedGoogle Scholar
  26. Gustavsen PH, Hoegholm A, Bang LE, Kristensen KS (2003) White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study. J Hum Hypertens 17(12):811–817PubMedGoogle Scholar
  27. Hadtstein C, Wühl E, Soergel M, Witte K, Schaefer F (2004) Normative values for circadian and ultradian cardiovascular rhythms in childhood. Hypertension 43(3):547–554PubMedGoogle Scholar
  28. Halberg F, Johnson EA, Nelson W, Runge W, Sothern R (1972) Autorhythmometry: procedures for physiologic self-assessments and their analysis. Physiol Teacher 1:1–11Google Scholar
  29. Harshfield GA, Alpert BS, Pulliam DA, Somes GW, Wilson DK (1994) Ambulatory blood pressure recordings in children and adolescents. Pediatrics 94(2):180–184PubMedGoogle Scholar
  30. Homma S, Ishii T, Malcom GT, Zieske AW, Strong JP, Tsugane S, Hirose N (2001) Histopathological modifications of early atherosclerotic lesions by risk factors – findings in PDAY subjects. Atherosclerosis 156(2):389–399PubMedGoogle Scholar
  31. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E (2014) 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311(5):507–520PubMedPubMedCentralGoogle Scholar
  32. Juonala M, Magnussen CG, Venn A, Dwyer T, Burns TL, Davis PH, Chen W, Srinivasan SR, Daniels SR, Kahonen M, Laitinen T, Taittonen L, Berenson GS, Viikari JS, Raitakari OT (2010) Influence of age on associations between childhood risk factors and carotid intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study, the Childhood Determinants of Adult Health Study, the Bogalusa Heart Study, and the Muscatine Study for the International Childhood Cardiovascular Cohort (i3C) Consortium. Circulation 122(24):2514–2520PubMedGoogle Scholar
  33. Jurko A Jr, Minarik M, Jurko T, Tonhajzerova I (2016) White coat hypertension in pediatrics. Ital J Pediatr 42:4PubMedPubMedCentralGoogle Scholar
  34. Kavey RE, Kveselis DA, Atallah N, Smith FC (2007) White coat hypertension in childhood: evidence for end-organ effect. J Pediatr 150:491–497Google Scholar
  35. King-Schultz L, Weaver AL, Cramer CH (2012) Correlation of blood pressure readings from 6-hour intervals with the daytime period of 24-hour ambulatory blood pressure monitoring in pediatric patients. J Clin Hypertens (Greenwich) 14(6):396–400Google Scholar
  36. Koivistoinen T, Hutri-Kahonen N, Juonala M, Aatola H, Koobi T, Lehtimaki T, Viikari JS, Raitakari OT, Kahonen M (2011) Metabolic syndrome in childhood and increased arterial stiffness in adulthood: the cardiovascular risk in young Finns study. Ann Med 43(4):312–319PubMedGoogle Scholar
  37. Kollias A, Dafni M, Poulidakis E, Ntineri A, Stergiou GS (2014) Out-of-office blood pressure and target organ damage in children and adolescents: a systematic review and meta-analysis. J Hypertens 32(12):2315–2331PubMedGoogle Scholar
  38. Lande MB, Meagher CC, Fisher SG, Belani P, Wang H, Rashid M (2008) Left ventricular mass index in children with white coat hypertension. J Pediatr 153(1):50–54PubMedPubMedCentralGoogle Scholar
  39. Lee SH, Kim JH, Kang MJ, Lee YA, Won Yang S, Shin CH (2011) Implications of nocturnal hypertension in children and adolescents with type 1 diabetes. Diabetes Care 34(10):2180–2185PubMedPubMedCentralGoogle Scholar
  40. Leung LC, Ng DK, Lau MW, Chan CH, Kwok KL, Chow PY, Cheung JM (2006) Twenty-four-hour ambulatory BP in snoring children with obstructive sleep apnea syndrome. Chest 130:1009–1017PubMedGoogle Scholar
  41. Leung AA, Nerenberg K, Daskalopoulou SS, et al. (2016) Hypertension Canada’s 2016 Canadian hypertension education program guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 32(5):569–588Google Scholar
  42. Li X, Li S, Ulusoy E, Chen W, Srinivasan SR, Berenson GS (2004) Childhood adiposity as a predictor of cardiac mass in adulthood: the Bogalusa heart study. Circulation 110:3488–3492PubMedGoogle Scholar
  43. Li Y, Thijs L, Boggia J, Asayama K, Hansen TW, Kikuya M, Bjorklund-Bodegard K, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Filipovsky J, Imai Y, Ibsen H, O’Brien E, Wang J, Staessen JA, International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes I (2014) Blood pressure load does not add to ambulatory blood pressure level for cardiovascular risk stratification. Hypertension 63(5):925–933PubMedGoogle Scholar
  44. Litwin M, Niemirska A, Ruzicka M, Feber J (2009) White coat hypertension in children: not rare and not benign? J Am Soc Hypertens 3(6):416–423PubMedGoogle Scholar
  45. Litwin M, Simonetti GD, Niemirska A, Ruzicka M, Wuhl E, Schaefer F, Feber J (2010) Altered cardiovascular rhythmicity in children with white coat and ambulatory hypertension. Pediatr Res 67(4):419–423Google Scholar
  46. Liu M, Takahashi H, Morita Y, Maruyama S, Mizuno M, Yuzawa Y, Watanabe M, Toriyama T, Kawahara H, Matsuo S (2003) Non-dipping is a potent predictor of cardiovascular mortality and is associated with autonomic dysfunction in haemodialysis patients. Nephrol Dial Transplantat 18:563–569Google Scholar
  47. Lubrano R, Paoli S, Spiga S, Falsaperla R, Vitaliti G, Gentile I, Elli M (2015) Impact of ambulatory blood pressure monitoring on the diagnosis of hypertension in children. J Am Soc Hypertens 9(10):780–784PubMedGoogle Scholar
  48. Lurbe E, Redon J, Liao Y, Tacons J, Cooper RS, Alvarez V (1994) Ambulatory blood pressure monitoring in normotensive children. J Hypertens 12:1417–1423PubMedGoogle Scholar
  49. 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 12:929–933PubMedGoogle Scholar
  50. Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V, Batlle D (2002) Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med 347:797–805PubMedGoogle Scholar
  51. Lurbe E, Sorof JM, Daniels SR (2004) Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 144:7–16PubMedGoogle Scholar
  52. Lurbe E, Torro I, Alvarez V, Nawrot T, Paya R, Redon J, Staessen J (2005) Prevalence, persistence and clinical significance of masked hypertension in youth. Hypertension 45:493–398PubMedGoogle Scholar
  53. Lurbe E, Agabiti-Rosei E, Cruickshank JK et al. (2016) 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens 34(10):1887–1920PubMedGoogle Scholar
  54. Matsuoka S, Kawamura K, Honda M, Awazu M (2002) White coat effect and white coat hypertension in pediatric patients. Pediatr Nephrol 17:950–953PubMedGoogle Scholar
  55. McGlothan KR, Wyatt RJ, Ault BH, Hastings MC, Rogers T, DiSessa T, Jones DP (2006) Predominance of nocturnal hypertension in pediatric renal allograft recipients. Pediatr Transplant 10(5):558–564PubMedGoogle Scholar
  56. Menghetti E, Virdis R, Strambi M, Patriarca V, Riccioni MA, Fossali E, Spagnolo A (1999) Blood pressure in childhood and adolescents: the Italian normal standards. J Hypertens 17:1363–1372PubMedGoogle Scholar
  57. Mitsnefes M, Flynn J, Cohn S, Samuels J, Blydt-Hansen T, Saland J, Kimball T, Furth S, Warady B (2010) Masked hypertension associates with left ventricular hypertrophy in children with CKD. J Am Soc Nephrol 21:137–144PubMedPubMedCentralGoogle Scholar
  58. Mitsnefes MM, Pierce C, Flynn J, Samuels J, Dionne J, Furth S, Warady B, for the CKiD Study Group (2016) Can office blood pressure readings predict masked hypertension? Pediatr Nephrol 31(1):163–166PubMedGoogle Scholar
  59. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents (1996) Update on the 1987 task force report on high blood pressure in children and adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics 98(4):649–658Google Scholar
  60. 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 114:555–576Google Scholar
  61. O’Brian EPJ, Little W, de Swiet M, Padfield P, Altman D, Bland M, Coats A, Atkins N (1993) The British Hypertension Society protocol for the evaluation of blood pressure measuring devices. J Hypertens 11(suppl 2):S43–S62Google Scholar
  62. O’Flynn AM, Madden JM, Russell AJ, Curtin RJ, Kearney PM (2015) Isolated nocturnal hypertension and subclinical target organ damage: a systematic review of the literature. Hypertens Res 38(8):570–575PubMedGoogle Scholar
  63. O’Sullivan JJ, Derrick G, Griggs P, Foxall R, Aitkin M, Wren C (1999) Ambulatory blood pressure in schoolchildren. Arch Dis Child 80:529–532PubMedPubMedCentralGoogle Scholar
  64. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michima M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y (2002) Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens 20(11):2183–2189PubMedGoogle Scholar
  65. Palatini P, Mormino P, Canali C, Santonastaso M, De Venuto G, Zanata G, Pessina AC (1994) Factors affecting ambulatory blood pressure reproducibility: results of the HARVEST trial: hypertension and ambulatory recording Venetia study. Hypertension 23:211–216PubMedGoogle Scholar
  66. Pall D, Juhasz M, Lengyel S, Molnar C, Paragh G, Fulesdi B, Katona E (2010) Assessment of target-organ damage in adolescent white-coat and sustained hypertensives. J Hypertens 28(10):2139–2144PubMedGoogle Scholar
  67. Parati G, Faini A, Valentini M (2006) Blood pressure variability: its measurement and significance in hypertension. Curr Hypertens Rep 8:199–204PubMedGoogle Scholar
  68. Parati G, Stergiou G, O’Brien E et al. (2014) European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. J Hypertens 32(7):1359–1366Google Scholar
  69. Park MK, Menard SW, Yuang C (2001) Comparison of auscultatory and oscillometric blood pressures. Arch Pediatr Adolesc Med 155:50–53PubMedPubMedCentralGoogle Scholar
  70. Perloff D, Sokolow M, Cowan R (1989) The prognostic value of ambulatory blood pressures. JAMA 249:2792–2798Google Scholar
  71. Pickering T (2002) Future developments in ambulatory blood pressure monitoring and self-blood pressure monitoring in clinical practice. Blood Pres Monit 7:21–25Google Scholar
  72. Pickering TG, Hall JE, Appel LJ et al. (2005) Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 45:142–161Google Scholar
  73. Portman RJ, Yetman RJ, West MS (1991) Efficacy of 24-hour ambulatory blood pressure monitoring in children. J Pediatr 118:842–849PubMedGoogle Scholar
  74. Prisant LM, Bottini PB, Carr AA (1996) Ambulatory blood pressure monitoring: methodologic issues. Am J Nephrol 16:190–201PubMedGoogle Scholar
  75. Redon J, Plancha E, Swift PA, Pons S, Munoz J, Martinez F (2010) Nocturnal blood pressure and progression to end-stage renal disease or death in nondiabetic chronic kidney disease stages 3 and 4. J Hypertens 28(3):602–607PubMedGoogle Scholar
  76. Reichert H, Lindinger A, Frey O, Mortzeck J, Kiefer J, Busch C, Hoffmann W (1995) Ambulatory blood pressure monitoring in healthy schoolchildren. Pediatr Nephrol 9:282–286PubMedGoogle Scholar
  77. Reusz GS, H¢bor M, Tulassay T, Sallay P, MiltÇny M (1994) 24-hour blood pressure monitoring in healthy and hypertensive children. Arch Dis Child 70:90–94PubMedPubMedCentralGoogle Scholar
  78. Rosner B, Cook NR, Daniels S, Falkner B (2013) Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988–2008. HypertensionGoogle Scholar
  79. Rucki S, Feber J (2001) Repeated ambulatory blood pressure monitoring in adolescents with mild hypertension. Pediatr Nephrol 16:911–915PubMedGoogle Scholar
  80. Samuels J, Ng D, Flynn JT, Mitsnefes M, Poffenbarger T, Warady BA, Furth S, Chronic Kidney Disease in Children Study G (2012) Ambulatory blood pressure patterns in children with chronic kidney disease. Hypertension 60(1):43–50PubMedPubMedCentralGoogle Scholar
  81. Saner C, Simonetti GD, Wuhl E, Mullis PE, Janner M (2016) Circadian and ultradian cardiovascular rhythmicity in obese children. Eur J Pediatr 175(8):1031–1038PubMedGoogle Scholar
  82. Schaefer F, Doyon A, Azukaitis K et al. (2016) Cardiovascular phenotypes in children with CKD: the 4C study. Clin J Am Soc Nephrol 12(1):19–28PubMedPubMedCentralGoogle Scholar
  83. Smulyan H, Safar ME (2011) Blood pressure measurement: retrospective and prospective views. Am J Hypertens 24(6):628–634PubMedGoogle Scholar
  84. Soergel 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 130:178–184PubMedGoogle Scholar
  85. 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 14:855–860PubMedGoogle Scholar
  86. Sorof JM, Cardwell G, Franco K, Portman RJ (2002a) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908PubMedGoogle Scholar
  87. Sorof JM, Poffenbarger T, Franco K, Bernard L, Portman RJ (2002b) Isolated systolic hypertension, obesity and hyperkinetic hemodynamic states in children. J Pediatr 140:660–666Google Scholar
  88. Stabouli S, Kotsis V, Toumanidis S, Papamichael C, Constantopoulos A, Zakopoulos N (2005) White-coat and masked hypertension in children: association with target-organ damage. Pediatr Nephrol 20(8):1151–1155PubMedGoogle Scholar
  89. Staessen JA, Fagard R, Thijs L, Amery A (1993) Fourier analysis of blood pressure profiles. Am J Hypertens 6(6 Pt 2):184S–187SPubMedGoogle Scholar
  90. Staessen JA, Thijs L, Fagard B, O’Brien ET, Clement D, de Leeuw PW, Mancia G, Nachev C, Palatini P, Parati G, Tuomilehto J, Webster J (1999) Predicting cardiovascular risk using conventional ambulatory blood pressure in older patients with systolic hypertension. JAMA 282:539–546PubMedGoogle Scholar
  91. Stanton A, Cox J, Atkins N, O’Malley K, O’Brian E (1992) Cumulative sums in quantifying circadian blood pressure patterns. Hypertension 19(1):93–101PubMedGoogle Scholar
  92. Stergiou GS, Yiannes NG, Rarra VC, Panagiotakos DB (2007) Home blood pressure normalcy in children and adolescents: the Arsakeion School study. J Hypertens 25:1375–1379PubMedGoogle Scholar
  93. Sulakova T, Janda J, Cerna J, Janstova V, Sulakova A, Slany J, Feber J (2009) Arterial HTN in children with T1DM – frequent and not easy to diagnose. Pediatr Diabetes 10(7):441–448PubMedGoogle Scholar
  94. Török K, Palfi A, Szelenyi Z, Molnar D (2008) Circadian variability of blood pressure in obese children. Nutr Metab Cardiovasc Dis 18(6):429–435PubMedGoogle Scholar
  95. Tracy RE, Newman WP 3rd, Wattigney WA, Srinivasan SR, Strong JP, Berenson GS (1995) Histologic features of atherosclerosis and hypertension from autopsies of young individuals in a defined geographic population: the Bogalusa heart study. Atherosclerosis 116(2):163–179PubMedGoogle Scholar
  96. Urbina E, Alpert B, Flynn J, Hayman L, Harshfield GA, Jacobson M, Mahoney L, McCrindle B, Mietus-Snyder M, Steinberger J, Daniels S (2008) Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment. A scientific statement from the American Heart Association. Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research. Hypertension 52:433–451Google Scholar
  97. van der Steen MS, Lenders JW, Graafsma SI, den Arend J, Thien T (1999) Reproducibility of ambulatory blood pressure monitoring in daily practice. J Human Hypertens 13:303–308Google Scholar
  98. Varda NM, Gregoric A (2005) Twenty-four-hour ambulatory blood pressure monitoring in infants and toddlers. Pediatr Nephrol 20:798–802PubMedGoogle Scholar
  99. Vaughan CJ, Murphy MB (1994) The use of ambulatory blood pressure monitoring in the evaluation of racial differences in blood pressure. J Cardiovasc Risk 1(2):132–135PubMedGoogle Scholar
  100. Verberk WJ, Kessels AG, de Leeuw PW (2008) Prevalence, causes and consequences of masked hypertension: a meta-analysis. Am J Hypertens 21:369–375Google Scholar
  101. Wang YC, Koval AM, Nakamura M, Newman JD, Schwartz JE, Stone PW (2013) Cost-effectiveness of secondary screening modalities for hypertension. Blood Press Monit 18(1):1–7PubMedPubMedCentralGoogle Scholar
  102. Ward A, Hansen P (1984) Accuracy and reproducibility of ambulatory blood pressure recorder measurements during rest and excercise. Springer, New YorkGoogle Scholar
  103. White WB, Dey HM, Schulman P (1989a) Assessment of the daily blood pressure load as a determinant of cardiac function in patients with mild-to-moderate hypertension. Am Heart J 118:782–795PubMedGoogle Scholar
  104. White WB, Schulman P, McCabe EJ, Dey HM (1989b) Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension. JAMA 261:873–877PubMedGoogle Scholar
  105. Witte K, Weissesr K, Neubeck M, Mutschler E, Lehmann K, Hopf R, Lemmer B (1993) Cardiovascular effects, pharmacokinetics, and converting enzyme inhibition of enalapril after morning versus evening administration. Clin Pharmacol Ther 54:177–186PubMedGoogle Scholar
  106. Wolfenstetter A, Simonetti GD, Poschl J, Schaefer F, Wühl E (2012) Altered cardiovascular rhythmicity in children born small for gestational age. Hypertension 60(3):865–870PubMedPubMedCentralGoogle Scholar
  107. Wühl E, Witte K, Soergel M, Mehls O, Schaefer F, German Working Group on Pediatric H (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20(10):1995–2007PubMedGoogle Scholar
  108. Wühl E, Hadtstein C, Mehls O, Schaefer F, Escape Trial Group (2004) Home, clinic, and ambulatory blood pressure monitoring in children with chronic renal failure. Pediatr Res 55(3):492–497PubMedGoogle Scholar
  109. Wühl E, Hadtstein C, Mehls O, Schaefer F, ESCAPE Trial Group (2005) Ultradian but not circadian blood pressure rhythms correlate with renal dysfunction in children with chronic renal failure. J Am Soc Nephrol 16(3):746–754PubMedGoogle Scholar
  110. Wühl E, Trivelli A, Picca S et al. (2009) Strict blood pressure control and renal failure progression in children. N Engl J Med 361:1639–1650Google Scholar
  111. Zakopoulos NA, Nanas SN, Lekakis JP, Vemmos KN, Kotsis VT, Pitiriga VC, Stamatelopoulos SF, Moulopoulos SD (2001) Reproducibility of ambulatory blood pressure measurements in essential hypertension. Blood Pres Monit 6:41–45Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Center for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany

Section editors and affiliations

  • Karen M. Redwine
    • 1
  1. 1.Department of Pediatrics, Arkansas Children's HospitalUniversity of Arkansas for Medical SciencesLittle RockUSA

Personalised recommendations