Ambulatory blood pressure status in children: comparing alternate limit sources

作者：Bell Cynthia S^*; Poffenbarger Tim S; Samuels Joshua A

来源：Pediatric Nephrology, 2011, 26(12): 2211-2217.

DOI：10.1007/s00467-011-1972-0

• Ambulatory blood pressure
• Pediatric hypertension
• Thresholds
• Normative percentiles

The American Heart Association has included alternate ambulatory blood pressure (ABP) limits for children published by Wuhl in 2002. These updated limits employ the same pediatric cohort data as the previous ABP limits published by Soergel in 1997 but differ in analysis technique. The implications of changing ABP limit source on the diagnosis of hypertension has yet to be examined in a large pediatric cohort. We reviewed 741 ABP monitorings performed in children referred to our hypertension clinic between 1991-2007. Hypertension was defined as 24-h mean blood pressure a parts per thousand yenaEuro parts per thousand 95th percentile or 24-h blood pressure load a parts per thousand yen25%, by Soergel and Wuhl limits separately. Six hundred seventy-three (91%) children were classified the same by both limit sources. Wuhl limits were more likely than Soergel to classify a child as hypertensive (443 vs. 409, respectively). There was an increased classification of prehypertension and decreased white-coat hypertension by the Wuhl method, whereas ambulatory and severe hypertension counts remained relatively the same by both limits sources. The use of either limit source will not significantly affect most clinical outcomes but should remain consistent over long-term research projects. Collection of new normative data from a larger, multiethnic population is needed for better measurement of ABP in children.

• 出版日期2011-12