title: Can office blood pressure readings predict masked hypertension?
abstract: BACKGROUND
  Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP).
  
  
  RESULTS
  We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7 %, and of abnormal BP load was 6-16 %.
  
  
  CONCLUSIONS
  These data suggest that masked hypertension is unlikely if the casual BP is found to be in the low normal range.
authors.affiliation: Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue ML 7022, Cincinnati, OH, 45229, USA. mark.mitsnefes@cchmc.org.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mitsnefes
authors.affiliation: Johns Hopkins University School of Public Health, Baltimore, MD, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Pierce
authors.affiliation: Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Flynn
authors.affiliation: University of Texas, Houston, TX, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Samuels
authors.affiliation: British Columbia University, Vancouver, BC, Canada.
authors.forename: Janis
authors.initials: J
authors.lastname: Dionne
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Furth
authors.affiliation: Section of Pediatric Nephrology, Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Warady
mesh_terms: D000204:Activity Cycles; D000293:Adolescent; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002170:Canada / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009819:Office Visits; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Ambulatory blood pressure monitoring; Children; Chronic kidney disease; Hypertension