title: Altered cardiovascular rhythmicity in children with white coat and ambulatory hypertension.
abstract: Adults with ambulatory hypertension or white coat hypertension (WCH) display abnormal cardiovascular rhythms. We studied cardiovascular rhythms by Fourier analysis of 24-h ambulatory blood pressure (BP) measurement profiles in 129 hypertensive children, 54 children with WCH, and 146 age-, height-, and gender-matched healthy subjects. The day/night mean arterial pressure ratio was lower in hypertensive and patients with WCH compared with controls (1.13 versus 1.16 versus 1.21, respectively; p < 0.0001). Eighty-five percent of controls were dippers compared with 74% of WCH (n.s.) and 64% of patients with ambulatory hypertension (p < 0.0001). The prevalence of 24-h rhythms was similar among the groups, but prevalence of 12-h BP rhythms was increased in hypertensive (67%) and WCH (72%) compared with controls (51%, p < 0.0001). The amplitudes of the 24-, 8-, and 6-h BP rhythms were reduced in hypertensive and WCH compared with controls (p < 0.05). Hypertensive and patients with WCH displayed delayed 24-, 12-, 8-, 6-h acrophases in comparison with controls (p < 0.05). In conclusion, hypertensive children exhibit abnormal cardiovascular rhythmicity compared with controls, especially a higher prevalence of nondipping compared with normotensive children. Abnormalities in patients with WCH are intermediate between healthy children and patients with ambulatory hypertension.
authors.affiliation: The Children's Memorial Health Institute, 04-730 Warsaw, Poland. m.litwin@czd.pl
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Litwin
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.forename: Anna
authors.initials: A
authors.lastname: Niemirska
authors.forename: Marcel
authors.initials: M
authors.lastname: Ruzicka
authors.forename: Elke
authors.initials: E
authors.lastname: Wühl
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.forename: Janusz
authors.initials: J
authors.lastname: Feber
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002319:Cardiovascular System / Q000503:physiopathology*; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D010507:Periodicity