The relationship between hypertension ethology in children with ambulatory blood pressure monitoring

SUMMARY INTRODUCTION: Early diagnosis and treatment of blood pressure abnormalities in children and adolescents are very crucial for decreasing the rates of cardiovascular morbidity and mortality for upcoming years of their life. Since the blood pressure level of children increases with the age and body size factors, hypertension in children cannot be defined with a single value as in adults (1). In childhood, blood pressure can vary significantly between medical examinations or even during the same test (2). Ambulatory blood pressure monitoring (ABPM) is becoming increasingly accepted as it provides extremely useful information for the diagnosis and management of hypertension (3). OBJECTIVE: The aim of this study is to verify the diagnosis of hypertension in children who are described as hypertensive via auscultatory/oscillometric measurements, to determine the pattern of hypertension, to determine the relationship between the etiology of hypertension and the values determined by the measurement of ambulatory blood pressure monitoring. METHODS: This study is carried out between 01.01.2006 and 12.08.2018 in Istanbul Medical Faculty Pediatric Nephrology Polyclinic among 146 girls and 203 boys aged between 5 and 18 years who have been diagnosed with hypertension via auscultatory / oscillometric measurements and applied ambulatory blood pressure monitoring. Patients shorter than 120 centimeters were excluded due to lack of reference data for ambulatory blood pressure monitoring. Polyclinic files, epicrisis and laboratory records of the cases were retrospectively analyzed. Obtained data were evaluated statistically. RESULTS: In our study, no statistically significant difference was found in terms of mean, day, night systolic-diastolic blood pressure values and systolic-diastolic blood pressure loads between patients with nephrological, endocrinological, cardiological, neurological hypertension, drug-related hypertension and essential hypertension. The incidence of isolated systolic hypertension was significantly higher in patients with endocrinologic hypertension than in patients with nephrological hypertension. CONCLUSION: Patients with isolated systolic hypertension should be evaluated for underlying endocrinological reasons, especially for obesity. Key Words: Childhood hypertension, Ambulatory blood pressure monitoring