Ambulatory blood pressure patterns in children and adolescents: influence of renin-sodium profiles.
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.
Harshfield
G A
GA
Department of Pediatrics, University of Tennessee, Memphis 38103.
Pulliam
D A
DA
Alpert
B S
BS
Stapleton
F B
FB
Willey
E S
ES
Somes
G W
GW
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
D012964:Sodium; D012083:Renin