Masked hypertension in children and its relationship with target organ damage

Abstract

Objective: Ambulatory blood pressure monitoring (ABPM) is important for the early diagnosis of masked hypertension. In present study, we aimed to determine the frequency of target organ damage in masked hypertension and establish a follow-up strategy in the early-stage for children.

Methods: The study population consisted of children and adolescents who were referred to our clinic for evaluation of suspected hypertension. A total of 120 children and adolescents aged 6 -17 years were investigated. Office blood pressure measurements were performed in all patients. Patients’ hypertension was evaluated with regard to target organ damage. Measurements were performed using Vicorder device. Patients underwent 24 h ambulatory blood pressure monitoring.

Results: ABPM revealed that 82 of 120 patients had hypertension. Hypertension was detected in 59 of 120 patients, by conventional blood pressure measurements. The frequency of masked hypertension was 42.7% (n=44), white coat hypertension 20.3% (n=21), and high ambulatory blood pressure was 36.8% (n=38). Increased carotid intima-media thickness was most frequently observed during the evaluation of early vascular changes in patients. We identified hypertensive retinopathy in 29 patients (24%), microalbuminuria in 21 (20.4%), and increased left ventricular mass index in 13 patients (10.8%). The frequency of hypertensive retinopathy was high, and increased carotid intima-media thickness and augmentation index were more common in masked hypertension.

Conclusion: In this study, higher frequency of masked hypertension was found in children than reported in the literature. J Clin Exp Invest 2015; 6 (2): 102-109

Key words: Children, masked hypertension, ambulatory blood pressure monitoring, end organ damage

Keywords

• Children, masked hypertension, ambulatory blood pressure monitoring, end organ damage

Çocuklarda maskeli hipertansiyon ve hedef organ hasarı ile ilişkisi

Öz

Amaç: Maskeli hipertansiyonun erken tanısı için ambulatuvar kan basıncı monitorizasyonu (ABPM) yapılması önemlidir. Bu çalışmamızın amacı maskeli hipertansiyon da hedef organ hasarı sıklığını belirlemek ve erken evrede çocukluk çağında izlem stratejilerini ortaya koymaktır. Yöntemler: Çalışmaya 6-17 yaş arasında olup kliniğimize hipertansiyon şüphesi ile gönderilen 120 çocuk hasta alındı. Tüm hastaların ofis kan basıncı ölçümleri gerçekleştirildi. Hipertansiyonu olan hastaların hedef organ hasarı taramaları yapıldı. Hastaların kan basıncı ölçümleri Vicorder ile yapıldı ve ABPM uygulandı. Bulgular: ABPM sonuçlarına göre 120 hastadan 82’si hipertansif bulunurken, klinikte 120 hastanın 59’u hipertansif idi. Maskeli hipertansiyon sıklığı % 42,7 (n=44), beyaz önlük hipertansiyon sıklığı %20,3 (n=21), ABPM’de hipertansiyon sıklığı %36,8 (n=38) olarak bulundu. Karotid intima media kalınlık artışı en sıklıkla görülen erken vasküler değişiklikti. Hipertansif retinopati 29 (%24) hastada, mikroalbuminüri 21(%20,4), artmış sol ventriküler kitle indeksi 13 (%10,8) hastada tespit edildi. Maskeli hipertansiyonu olan hastalarda hipertansif retinopati sıklığı daha yüksek olup, daha sıklıkla karotid intima media kalınlığı ve augmentasyon indekslerinde artışa rastlandı.Sonuç: Sonuç olarak, çalışmamızda çocuklarda maskeli hipertansiyon sıklığı literatürde bildirilenden daha yüksek bulundu

Anahtar Kelimeler

• Çocuk, maskeli hipertansiyon, ambulatuvar kan basıncı ölçümü, hedef organ hasarı

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