title: Blood pressure profiles 5 to 10 years after transplant in pediatric solid organ recipients.
abstract: Arterial hypertension is a major risk factor for cardiovascular disease after solid organ transplantation, emphasizing the need for blood pressure (BP) monitoring. The authors studied 24-hour ambulatory BP monitoring (ABPM) parameters (index, load, dipping) and their predictive value with regard to hypertension as well as correlations with graft function and metabolic parameters such as obesity and dyslipidemias. The ABPM profiles of 111 renal, 29 heart, and 13 liver transplant recipients were retrospectively analyzed 5 to 10 years after transplant (median 5.1 years). The BP profiles among the different transplant groups were similar. The BP index and load were abnormal especially at nighttime and the nocturnal BP dipping was often blunted (in 49% to 83% of the patients). The BP variables were found to be equally valued when assessing hypertension. BP load of 50% instead of 25% seems to be a more adequate cutoff value. The BP variables correlated poorly with the metabolic parameters and kidney function. Antihypertensive medication did not notably change the ABPM profile in renal transplant recipients. Hypertension, including nocturnal hypertension, is present in children receiving solid organ transplant, underlining the importance of use of ABPM in the follow-up of these patients.
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Juuso
authors.initials: J
authors.lastname: Tainio
authors.forename: Erik
authors.initials: E
authors.lastname: Qvist
authors.forename: Jenni
authors.initials: J
authors.lastname: Miettinen
authors.forename: Tuula
authors.initials: T
authors.lastname: Hölttä
authors.forename: Mikko
authors.initials: M
authors.lastname: Pakarinen
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000150:complications / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D015994:Incidence; D007223:Infant; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D066027:Transplant Recipients