Should mean arterial pressure be included in the definition of ambulatory hypertension in children?
Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu časopisecké články
- MeSH
- ambulantní monitorování krevního tlaku * MeSH
- analýza rozptylu MeSH
- arteriální tlak * MeSH
- časové faktory MeSH
- cirkadiánní rytmus MeSH
- diastola MeSH
- hypertenze klasifikace diagnóza patofyziologie MeSH
- lidé MeSH
- mladiství MeSH
- prediktivní hodnota testů MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- rozdělení chí kvadrát MeSH
- systola MeSH
- terminologie jako téma MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The diagnosis of hypertension (HTN)/normotension (NT) on ambulatory blood pressure monitoring (ABPM) is usually based on systolic (SBP) or diastolic blood pressure (DBP). The goal of this study was to analyze whether inclusion of mean arterial pressure (MAP) improves the detection of HTN on ABPM. METHODS: We retrospectively studied ABPM records in 229 children (116 boys, median age = 15.3 years) who were referred for evaluation of HTN. A diagnosis of HTN was made if: (A) MAP or SBP or DBP was ≥ 1.65 SDS (95th percentile); (B) SBP or DBP was ≥ 1.65 SDS (95th percentile), during 24-h or daytime or night-time in both definitions. RESULTS: Using definition A, 46/229 patients had HTN compared to definition B by which only 37/229 patients had HTN (p = 0.001). The level of agreement between the two definitions was very good (kappa = 0.86 ± 0.04), however nine patients (19.5 %) were missed by not using MAP in the definition of HTN. These nine patients had only mild HTN with a median Z score of 1.69. CONCLUSIONS: The inclusion of MAP in the definition of ambulatory HTN significantly increased the number of hypertensive patients. MAP may be very helpful in detecting mild HTN in patients with normal/borderline SBP and DBP.
Department of Pediatrics University Hospital Ostrava 17 listopadu 1790 708 52 Ostrava Czech Republic
Zobrazit více v PubMed
J Pediatr. 1997 Feb;130(2):178-84 PubMed
J Hypertens. 2009 Sep;27(9):1719-42 PubMed
Pediatr Nephrol. 2008 Dec;23(12):2285-6 PubMed
J Pediatr. 2004 Jan;144(1):7-16 PubMed
Pediatr Nephrol. 2011 May;26(5):775-81 PubMed
Diabetes Care. 2008 Apr;31(4):720-5 PubMed
N Engl J Med. 2002 Sep 12;347(11):797-805 PubMed
Hypertension. 2002 Apr;39(4):903-8 PubMed
Pediatr Nephrol. 2004 Sep;19(9):1004-13 PubMed
Kidney Int. 2006 Feb;69(4):699-705 PubMed
Biometrics. 1977 Mar;33(1):159-74 PubMed
Pediatr Nephrol. 2011 Dec;26(12):2211-7 PubMed
Hypertension. 2008 Sep;52(3):433-51 PubMed
J Hypertens. 2007 Jun;25(6):1105-87 PubMed
Diabetologia. 2001 Jul;44(7):865-73 PubMed
Pediatr Nephrol. 2006 May;21(5):672-6 PubMed
Pediatr Diabetes. 2009 Nov;10(7):441-8 PubMed
Hypertension. 2000 Mar;35(3):844-51 PubMed
Hypertension. 2003 Dec;42(6):1206-52 PubMed
Diabetes Care. 2004 Feb;27(2):510-6 PubMed
Crit Care. 2011;15(3):R135 PubMed
Clin J Am Soc Nephrol. 2011 Apr;6(4):870-6 PubMed
N Engl J Med. 2009 Oct 22;361(17):1639-50 PubMed
Pediatr Nephrol. 2009 Apr;24(4):823-31 PubMed
BMJ. 2008 May 17;336(7653):1117-20 PubMed
J Hypertens. 2003 May;21(5):821-48 PubMed
J Clin Endocrinol Metab. 1998 Sep;83(9):3190-3 PubMed