title: The Association of Pediatric Obesity With Nocturnal Non-Dipping on 24-Hour Ambulatory Blood Pressure Monitoring.
abstract: BACKGROUND
  Obesity has been linked with abnormal nocturnal dipping of blood pressure (BP) in adults, which in turn is associated with poor cardiovascular outcomes. There are few data regarding abnormal dipping status in the obese pediatric population. The goal of this study was to further describe the relationship between obesity and non-dipping status on ambulatory blood pressure monitor (ABPM) in children.
  
  
  METHODS
  We conducted a cross-sectional study using a database of patients aged 5-21 years who had undergone 24-hour ABPM at Seattle Children's Hospital from January 2008 through May 2014. Subjects were grouped by body mass index (BMI) into lean (BMI 15th-85th percentile) and obese (BMI >95th percentile) groups.
  
  
  RESULTS
  Compared to lean subjects (n = 161), obese subjects (n = 247) had a prevalence ratio (PR) for non-dipping of 2.15, adjusted for race (95% confidence interval (CI) = 1.25-3.42). Increasing severity of obesity was not further associated with nocturnal non-dipping. Nocturnal non-dipping was not associated with left ventricular hypertrophy (PR = 1.01, 95% CI = 0.71-1.44).
  
  
  CONCLUSIONS
  These results suggest that in children, just as in adults, obesity is related to a relatively decreased dipping in nocturnal BP.
authors: Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA; ianmacumber@gmail.com.
authors: Ian R
authors: IR
authors: Macumber
authors: Department of Epidemiology, University of Washington, Seattle, Washington, USA.
authors: Noel S
authors: NS
authors: Weiss
authors: Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA;
authors: Susan M
authors: SM
authors: Halbach
authors: Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA;
authors: Coral D
authors: CD
authors: Hanevold
authors: Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA;
authors: Joseph T
authors: JT
authors: Flynn
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors; D014861:Washington; D055815:Young Adult
keywords: ABPM; ambulatory blood pressure monitor; blood pressure; hypertension; nocturnal dipping; obesity; pediatrics.