Ambulatory blood pressure monitoring in children with aortic coarctation and kidney transplantation.
BACKGROUND
Ambulatory blood pressure monitoring (ABPM) has been found to be of significant importance in clinical practice because numerous blood pressure (BP) measurements may be made throughout the 24-hour period.


OBJECTIVE
To assess the clinical utility of ABPM in children with secondary hypertension.


METHODS
We studied 37 patients (21 boys and 16 girls), with a mean age of 16.4 +/- 4.1 years, after kidney transplantation and 38 patients (27 boys and 11 girls), with a mean age of 10.2 +/- 2.1 years, after surgical correction of aortic coarctation. Data, expressed as mean +/- SD, were analyzed after dividing the patients into 4 groups. Group A consisted of 25 patients receiving antihypertensive therapy; group B included 12 patients not receiving antihypertensive therapy. Group C included 25 patients operated on before 3 years of age (8 +/- 7 months of age); group D included 13 patients operated on after 3 years of age (74 +/- 29 months of age).


RESULTS
In groups A and B, casual BP measurement showed that 16 of 37 patients (43%) were hypertensive; 24-hour ABPM detected a larger number of patients who were hypertensive (23 of 37, 62%); there were 18 in group A and 5 in group B. In groups C and D, casual BP measurement identified 6 of 38 (15%) patients as hypertensive, whereas 24-hour ABPM again identified a higher number (13 of 38, 34%).


CONCLUSIONS
Our findings confirm that 24-hour ABPM is more sensitive than casual BP in detecting abnormal BP in patients at high risk for secondary hypertension.
Giordano
U
U
Sports Medicine Department and the Nephrology and Dialysis Department, Bambino Gesù Children's Hospital Research Institute, Rome, Italy.
Matteucci
M C
MC
Calzolari
A
A
Turchetta
A
A
Rizzoni
G
G
Alpert
B S
BS
D000293:Adolescent; D001017:Aortic Coarctation / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology*; D008297:Male; D012307:Risk Factors; D012680:Sensitivity and Specificity