title: Home and ambulatory blood pressure to identify white coat and masked hypertension in the pediatric patient.
abstract: OBJECTIVE
  To evaluate the effect of the environment and the observer on the measurement of blood pressure (BP) as well as to compare home BP (HBP) and ambulatory BP (ABP) measurements in the diagnosis of white coat hypertension (WCH) and masked hypertension (MH) in children and adolescents with hypertension (HT).
  
  
  METHODS
  BP of 40 patients with HT (75% of which had secondary HT and were on antihypertensive medication), mean age 12.1 years was evaluated through casual measurements at the clinic and at the HT unit, HBP for 14 days with the OMRON HEM 705 CP monitor (Omron, Tokyo, Japan) and ABP performed with SPACELABS 90207 (Spacelabs, Redmond, WA), for 24 h.
  
  
  RESULTS
  HT was diagnosed at the doctor's office by ABP and HBP in 30/40, 27/40, and 31/40 patients, respectively. Based on office BP and ABP, 60% of patients were normotensive, 17.5% HT, 7.5% had WCH, and 15% had MH, whereas based on office BP and HBP 65, 12.5, 10, and 12.5% of patients were classified according to these diagnoses, respectively. There was considerable diagnostic agreement of HT by ABP and HBP (McNemar test, P < 0.01) (κ = 0.56).
  
  
  CONCLUSIONS
  In hypertensive children and adolescents, HBP and ABP present comparable results. HBP appears to be a useful diagnostic test for the detection of MH and WCH in pediatric patients.
authors.affiliation: Department of Pediatrics, Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. erika.furusawa@icr.usp.br
authors.forename: Érika A
authors.initials: ÉA
authors.lastname: Furusawa
authors.forename: Ulysses D
authors.initials: UD
authors.lastname: Filho
authors.forename: Décio Mion
authors.initials: DM
authors.lastname: Junior
authors.forename: Vera H
authors.initials: VH
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D010824:Physicians' Offices; D012931:Social Environment
chemical_list: D000959:Antihypertensive Agents