Determination of the frequency of hypertension in pediatric patients undergoing chemotherapy with ABPM

Objective: Early and accurate diagnosis of hypertension in childhood is crucial; however, measuring blood pressure is challenging due to the variety of techniques and biological differences in blood pressure values. Ambulatory blood pressure monitoring (ABPM) is a portable electronic device that can measure blood pressure during the day and night at adjustable intervals, allowing patients to maintain their daily activities. The goal of detecting and treating hypertension in patients receiving chemotherapy is to reduce target organ damage and associated morbidity and mortality rates. Early diagnosis and treatment of hypertension with ABPM aim to protect children from hypertension-related complications in later years. Materials and Methods: The study included 26 patients aged 4-18 years, receiving active chemotherapy and in remission, with no prior hypertension diagnosis, from the Pediatric Oncology and Pediatric Hematology departments of Celal Bayar University. The patients underwent EKG, blood pressure measurement, and AKBM monitoring at the pediatric cardiology clinic. Results: The average age of the patients was 11.07±4.36 years, with the youngest being 4 years old and the oldest being 17 years old. Seventeen patients (65.4%) were male, and 9 (34.6%) were female. The average height was 143.61±22.99 cm, and the average heart rate was 93.19±17.13 bpm. Fifteen patients (57.7%) had lymphoproliferative tumors, and 11 (42.3%) had solid tumors. ABPM results showed that 23 patients (88.5%) were normotensive, 2 patients (7.7%) were hypertensive, and 1 patient (3.8%) was hypotensive. Eighteen patients (69.2%) were non-dippers, and 8 patients (30.8%) were dippers. There was no statistically significant difference in ambulatory blood pressure measurements, pulse values, measured manual blood pressure values, or the rate of nighttime blood pressure decline between the solid tumor and lymphoproliferative tumor groups. Conclusion: In childhood cancers, the risk of hypertension (HT) is high due to both the cancer itself and the treatments used. In these children, the early diagnosis of HT is crucial in reducing the risk of future long-term cardiovascular diseases, and ambulatory blood pressure monitoring (ABPM) is an important diagnostic method. HT is a significant cause of mortality and morbidity in long-term cardiovascular diseases. The aim of this study is to identify patients with high HT risk in childhood cancers early and to prevent mortality and morbidity Keywords: ambulatory blood pressure monitoring, hypertension, children, chemotherapy