Circadian rhythm of blood pressure in children with reference to normal and diseased children.
Circadian rhythms of blood pressure in children were investigated using ambulatory blood pressure monitoring (ABPM). The subjects were 58 normal children (26 boys and 32 girls), 10 children with orthostatic dysregulation (OD) consisting of (three boys and seven girls) and 13 children taking prednisolone (nine boys and four girls). Systolic pressure in the normal group increased from early morning, peaked in the afternoon and gradually dropped thereafter. Blood pressure in the 22:00-05:30 h time range was significantly lower than in other time ranges. Blood pressure in the OD group was generally lower than in the normal group, while that in the steroid group tended to be higher. Systolic mid-line estimating statistic of rhythm (MESOR) was significantly higher in boys than girls in both 10-12 year olds and 13-15 year olds according to Cosinor analysis. However, no increase in MESOR was observed in either boys or girls between the 10-12 year and 13-15 year age groups. The OD group showed lower diastolic MESOR than the normal group and the steroid group showed higher systolic MESOR. Seventy-two per cent of those in the normal group manifested significant circadian rhythm. Only 50% of 10-12 year olds manifested circadian rhythm, whereas the figure for 13-15 year olds increased to 80-90%, suggesting that a pacemaker regulating circadian rhythm comes into effect at puberty. The percentage of those who manifested circadian rhythm in the OD group and steroid group was about 60%, lower than in the normal group.
Watanabe
T
T
Department of Pediatrics, National Nagoya Hospital, Japan.
Nagashima
M
M
Hojo
Y
Y
D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012737:Sex Factors
D011239:Prednisolone