Arterial HTN in children with T1DM--frequent and not easy to diagnose
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
19500279
DOI
10.1111/j.1399-5448.2009.00514.x
PII: PDI514
Knihovny.cz E-resources
- MeSH
- Albuminuria epidemiology MeSH
- Blood Pressure Monitoring, Ambulatory MeSH
- Circadian Rhythm MeSH
- Diabetes Mellitus, Type 1 complications MeSH
- Diabetic Angiopathies diagnosis physiopathology MeSH
- Diastole MeSH
- Child MeSH
- Glycated Hemoglobin analysis MeSH
- Hypertension complications diagnosis physiopathology MeSH
- Creatinine urine MeSH
- Blood Pressure MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Predictive Value of Tests MeSH
- Retrospective Studies MeSH
- Systole MeSH
- Body Weight MeSH
- Body Height MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Glycated Hemoglobin A MeSH
- Creatinine MeSH
INTRODUCTION: To evaluate the diagnostic efficacy of the office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension (HTN) in children with diabetes mellitus type 1 (T1DM). METHODS: We analyzed OBP and ABPM measurements in 84 diabetic children (43 boys) obtained at a median age of 14.9 yr and 6.3 +/- 3.5 yr after diagnosis of T1DM. OBP and ABPM results were converted into standard deviation scores (SDS). In addition, we analyzed blood pressure loads and nighttime dipping. The comparison between OBP and ABPM was performed using kappa coefficient and receiver operator curve (ROC). RESULTS: HTN was diagnosed in 43/84 (51%) patients using OBP (>95th percentile), and in 24/84 (29%) patients using ABPM ( > or = 95th percentile during 24 h, day or night). Both methods were in agreement in 33 ABPM normotensive and 16 ABPM hypertensive patients (most had nighttime HTN); 32% patients had white-coat HTN and 9.5% patients had masked HTN. The kappa coefficient was 0.175 (95% CI from -0.034 to 0.384) suggesting poor agreement between OBP and ABPM. Diastolic OBP was a better predictor of ABPM HTN (ROC area under the curve (AUC) = 0.71 +/- 0.06) than systolic OBP (AUC = 0.58 +/- 0.07). The percentage of non-dippers ranged from 7 to 23% in ABPM normotensive patients, and 21-42% in ABPM hypertensive patients who also had significantly higher BP loads (p < 0.0001). CONCLUSION: Children with T1DM often suffer from nocturnal, white coat- and masked HTN, which can not be assessed and predicted by the OBP.
References provided by Crossref.org
Masked Hypertension in Healthy Children and Adolescents: Who Should Be Screened?
Early Vascular Aging in Children With Type 1 Diabetes and Ambulatory Normotension
Should mean arterial pressure be included in the definition of ambulatory hypertension in children?
Ambulatory blood pressure monitoring in pediatric renal transplantation
