Data unveiled today at the American Society of Hypertension Inc.‘s 25th Annual Scientific Meeting and Exposition (ASH 2010) suggest children and adolescents of parents with hypertension and larger waist (WC) and hip circumference (HC) should be evaluated for hypertension even if they exhibit normal blood pressure (BP) levels in the doctor’s office. Investigators found that these patients exhibited masked hypertension, which occurs when BP levels are normal when measured inside the doctor’s office but increase when measured outside the doctor’s office, when evaluated with ambulatory blood pressure monitoring (ABPM). Masked hypertension is not rare in children and adolescents and implies an increased risk of cardiovascular disease.
“The children found to be hypertensive with ABPM were not even in a pre-hypertensive state in the doctor’s office. Their blood pressure was normal,” said lead author of the study, Claudia Maria Salgado, M.D., Ph.D., adjunct professor, Department of Pediatrics and Hypertension League, Federal University of Goiás, Brazil. “The fact that the blood pressure rates for these patients escalated so significantly is alarming and warrants attention, if additional data confirm these findings.”
A total of 110 children and adolescents (aged 5-15) were included in this prospective study. Of the 110 enrolled, 99 completed the BP evaluation. Participants were evaluated for family BP history, weight, height, body mass index and WC/HC. Data from 82 subjects who had an office BP lower than the 95th percentile were analyzed. Of these, 70 had normal BP (<90th percentile) and 12 were pre-hypertensive (>90th and
<95th percentile). Through ABPM, 10 were diagnosed with masked hypertension. None of those considered pre-hypertensive presented with hypertension in the ambulatory setting. Children of hypertensive parents had more than a four-fold increased risk (p=.032). Children of hypertensive parents with a WC/HC ≥ .09 (abdominal obesity) had a nine-fold increased risk (p=.020) of having masked hypertension. Age, sex, ethnicity and excess weight (simple obesity and overweight) had no influence on risk.
Patients were studied in an outpatient clinic specializing in hypertension. Office BP was measured with an OMRON Hem-705CP (4th Task Force). Three measurements were taken on three separate occasions. Ambulatory blood pressure was taken with SPACELABS 90201 equipment with the same size sleeve as used in the office measurement. One measurement was taken every 20 minutes during the period of wakefulness (7 a.m. - 10 p.m.) and every 30 minutes during the period of sleep (10 p.m. -7 a.m.).
About the American Society of Hypertension
The American Society of Hypertension, Inc. (ASH) is the largest U.S. professional organization of scientific investigators and healthcare professionals committed to eliminating hypertension and its consequences. ASH is dedicated to promoting strategies to prevent hypertension and to improving the care of patients with hypertension and associated disorders. The Society serves as a scientific forum that bridges current hypertension research with effective clinical treatment strategies for patients.
Source: American Society of Hypertension (ASH)