title: Comparisons of Office and 24-Hour Ambulatory Blood Pressure Monitoring in Children with Obstructive Sleep Apnea.
abstract: To compare office blood pressure (BP) and 24-hour ambulatory BP (ABP) monitoring to facilitate the diagnosis and management of hypertension in children with obstructive sleep apnea (OSA).
  
  
  
  Children aged 4-16 years with OSA-related symptoms were recruited from a tertiary referral medical center. All children underwent overnight polysomnography, office BP, and 24-hour ABP studies. Multiple linear regression analyses were applied to elucidate the association between the apnea-hypopnea index and BP. Correlation and consistency between office BP and 24-hour ABP were measured by Pearson correlation, intraclass correlation, and Bland-Altman analyses.
  
  
  
  In the 163 children enrolled (mean age, 8.2 ± 3.3 years; 67% male). The prevalence of systolic hypertension at night was significantly higher in children with moderate-to-severe OSA than in those with primary snoring (44.9% vs 16.1%, P = .006). Pearson correlation and intraclass correlation analyses revealed associations between office BP and 24-hour BP, and Bland-Altman analysis indicated an agreement between office and 24-hour BP measurements. However, multiple linear regression analyses demonstrated that 24-hour BP (nighttime systolic BP and mean arterial pressure), unlike office BP, was independently associated with the apnea-hypopnea index, after adjustment for adiposity variables.
  
  
  
  Twenty-four-hour ABP is more strongly correlated with OSA in children, compared with office BP.
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shuenn-Nan
authors.initials: SN
authors.lastname: Chiu
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Weng
authors.affiliation: Sleep Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Pei-Lin
authors.initials: PL
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: hsuwc@ntu.edu.tw.
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Hsu
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000553:Ambulatory Care; D001795:Blood Pressure Determination / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D015331:Cohort Studies; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D017286:Polysomnography / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology; D013624:Taiwan; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000453:epidemiology
keywords: blood pressure; child; polysomnography; sleep apnea syndromes