title: Utility of ambulatory blood pressure monitoring in the evaluation of elevated clinic blood pressures in children.
abstract: Although ambulatory blood pressure monitoring (ABPM) is recognized for its role in assessing white coat hypertension, other uses include evaluation of treatment adequacy, nocturnal hypertension, dipping status, and hypertension severity. We performed a retrospective study of ABPMs completed at a single center from November 2007 to October 2011 to determine the frequency of white coat hypertension, prehypertension, and hypertension in children and the correlation of these findings with office BPs. A total of 247 ABPMs were performed in 206 children, ages 4-20 years, including 48 recordings in 39 diabetic patients and 64 recordings in treated hypertensive patients. We found a poor correlation between hypertensive status based on clinic BP and diagnosis on ABPM, and evidence for a white coat effect. Among treated patients, ABPM results resulted in medication changes in 63%. We conclude that ABPM is a useful tool for characterizing hypertensive status and treatment adequacy in children.
authors.affiliation: Division of Nephrology, Seattle Children's Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: susan.halbach@seattlechildrens.org.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Halbach
authors.affiliation: Mary Bridge Children's Hospital, Tacoma, WA, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Hamman
authors.affiliation: Division of Nephrology, Seattle Children's Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Karyn
authors.initials: K
authors.lastname: Yonekawa
authors.affiliation: Division of Nephrology, Seattle Children's Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Coral
authors.initials: C
authors.lastname: Hanevold
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009819:Office Visits; D011237:Predictive Value of Tests; D058246:Prehypertension / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
keywords: ABPM; Blood pressure; child; hypertension