title: Ambulatory blood pressure patterns in children and adolescents: influence of renin-sodium profiles.
abstract: A renin-sodium nomogram for normotensive children and adolescents was developed at our institution. The ambulatory blood pressure patterns of subjects classified by the nomogram were then compared. A biracial sample of 159 children and adolescents were classified as having a low, intermediate, or high renin-sodium profile based on the relationship between their plasma renin activity and 24-hour urinary sodium excretion. Casual (106/58 vs 107/61 vs 106/62 mm Hg) and awake (116/69 vs 117/69 vs 116/70 mm Hg) blood pressure values were comparable among subjects with low, intermediate, and high renin-sodium profiles. Subjects with high renin-sodium profiles, however, had a smaller decline in systolic blood pressure with sleep than did subjects with low renin-sodium profiles (7 vs 11 mm Hg; P less than .04), and higher diastolic blood pressure readings during sleep than subjects with intermediate renin-sodium profiles (65 vs 62 mm Hg; P less than .05). Subjects with high renin-sodium profiles also had greater variance of diastolic blood pressure readings during sleep than either subjects with low renin-sodium profiles (P less than .01) or those with intermediate renin-sodium profiles (P less than .02). The blunted nocturnal decline and increased nocturnal variance of blood pressure among subjects with high renin-sodium profiles may be a marker or mechanism for the future development of essential hypertension.
authors.affiliation: Department of Pediatrics, University of Tennessee, Memphis 38103.
authors.forename: G A
authors.initials: GA
authors.lastname: Harshfield
authors.forename: D A
authors.initials: DA
authors.lastname: Pulliam
authors.forename: B S
authors.initials: BS
authors.lastname: Alpert
authors.forename: F B
authors.initials: FB
authors.lastname: Stapleton
authors.forename: E S
authors.initials: ES
authors.lastname: Willey
authors.forename: G W
authors.initials: GW
authors.lastname: Somes
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D012016:Reference Values; D012083:Renin / Q000097:blood*; D012307:Risk Factors; D012964:Sodium / Q000652:urine*; D013599:Systole / Q000502:physiology
chemical_list: D012964:Sodium; D012083:Renin