title: Masked hypertension is prevalent in children with sickle cell disease: a Midwest Pediatric Nephrology Consortium study.
abstract: BACKGROUND
  The prevalence of hypertension and abnormal blood pressure (BP) patterns on 24-h ambulatory BP monitoring (ABPM) remains unknown in children with sickle cell disease (SCD).
  
  
  METHODS
  Thirty-eight asymptomatic children with sickle cell disease (SCD) (12 HbSS receiving routine care, 13 HbSC, and 13 HbSS receiving chronic transfusion therapy) underwent 24-h ABPM. Average clinic BP, demographic and biochemical characteristics were collected.
  
  
  RESULTS
  Median age was 13 years (range 11-16), body mass index (BMI) 19.1 kg/m(2) (range 18.2-21.1), and 50% were male. Seventeen subjects (43.6%) had ambulatory hypertension, while 4 (10.3%) were hypertensive based on their clinic BP. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) dip were 8.3 ± 5.9% and 14.7 ± 7.6% respectively. Twenty-three subjects (59%) had impaired SBP dipping, 7 (18%) had impaired DBP dipping, and 5 (13%) had reversed dipping. Clinic and ABP classification were modestly correlated (rho = 0.38, P = 0.02).
  
  
  CONCLUSIONS
  Abnormalities in ABP measurements and patterns in children with SCD are prevalent and require more attention from heath care providers. ABPM is a valuable tool in identifying masked hypertension and abnormalities in circadian BP.
authors.affiliation: Division of Pediatric Nephrology and Hypertension, MUSC Children's Hospital, 96 Jonathan Lucas Street, CSB-428, Charleston, SC 29425, USA. shatat@musc.edu
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Shatat
authors.forename: Sherron M
authors.initials: SM
authors.lastname: Jakson
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Blue
authors.forename: Mary A
authors.initials: MA
authors.lastname: Johnson
authors.forename: John K
authors.initials: JK
authors.lastname: Orak
authors.forename: Ram
authors.initials: R
authors.lastname: Kalpatthi
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence