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Pediatr Nephrol. 2016 Jan;31(1):163-6. doi: 10.1007/s00467-015-3212-5. Epub 2015 Sep 28.

Can office blood pressure readings predict masked hypertension?

Author information

1
Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue ML 7022, Cincinnati, OH, 45229, USA. mark.mitsnefes@cchmc.org.
2
Johns Hopkins University School of Public Health, Baltimore, MD, USA.
3
Seattle Children's Hospital, Seattle, WA, USA.
4
University of Texas, Houston, TX, USA.
5
British Columbia University, Vancouver, BC, Canada.
6
The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
7
Section of Pediatric Nephrology, Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.

Abstract

BACKGROUND:

Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP).

METHODS/RESULTS:

We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7 %, and of abnormal BP load was 6-16 %.

CONCLUSIONS:

These data suggest that masked hypertension is unlikely if the casual BP is found to be in the low normal range.

KEYWORDS:

Ambulatory blood pressure monitoring; Children; Chronic kidney disease; Hypertension

PMID:
26416480
PMCID:
PMC4651753
DOI:
10.1007/s00467-015-3212-5
[Indexed for MEDLINE]
Free PMC Article

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