ESPN 53rd Annual Meeting

ESPN 2021


 
Ambulatory Blood Pressure Monitoring and End Organ Damage in Childhood Hypertension
MUSA ÖZTÜRK 1 Z. BIRSIN ÖZÇAKAR 2 NILGÜN ÇAKAR 2 BEYZA DOĞANAY 3 FATOŞ YALÇINKAYA 2

1- ANKARA UNIVERSITY FACULTY OF MEDICINE- DEPARTMENTS OF PEDIATRICS
2- ANKARA UNIVERSITY FACULTY OF MEDICINE- PEDIATRIC NEPHROLOGY
3- ANKARA UNIVERSITY FACULTY OF MEDICINE- BIOSTATISTICS
 
Introduction:

Childhood hypertension (HT) is a chronic disease that requires careful and delicate follow-up. Many data obtained from ambulatory blood pressure monitoring (ABPM) guide us in the management of HT. The purpose of evaluating these measurements is to obtain the most accurate and earliest prediction for the severity of HT and end organ damage.

Material and methods:

Files of 269 children who were followed up with the diagnosis of HT were evaluated retrospectively. The presence of end organ damage was recorded together with the ABPM data of the patients at the time of diagnosis. Z scores were obtained from the ABPM outputs using the statistical LMS method and the relationship to end organ damage was investigated.

Results:

Left ventricular hypertrophy (LVH) and hypertensive retinopathy were found in 18% and 9% of the patients who underwent cardiological and ophthalmological examination, respectively. The relationship of ABPM data Z scores and blood pressure (BP) loads with LVH is given in Table 1. 24-hour, day and night mean systolic BP Z scores of the patients with LVH were found to be significantly higher as compared to the patients without. In addition, systolic day and night BP loads were significantly higher in the group with LVH. It was calculated that one unit increase in the mean daytime systolic BP Z score increases the risk of LVH by 1.35 times and ten percent increase in systolic BP load increases the risk 1.16 times.

Conclusions:

These results show that evaluation of the ABPM data in childhood hypertension through the incoming studies will increase the chance of early diagnosis and treatment. At this point, the real question is what should be the ABPM cut-off points to prevent organ damage.