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Comparison between casual blood pressure and ambulatory blood pressure monitoring parameters in healthy and hypertensive adolescents

Koch, Vera Herminaa; Colli, Anitab; Saito, Maria Ignezb; Furusawa, Erika Araia; Ignes, Ednac; Okay, Yassuhikoa; Júnior, Décio Mionc

Data Analysis and Statistical Methods

Casual blood pressure measurements were compared with mean ambulatory blood pressure values during wakefulness and sleep in 45 normotensive and 30 hypertensive adolescents of both sexes aged 10–18 years. Two sets of auscultatory casual blood pressure were obtained, one in a pediatric office setting (office blood pressure), performed by the physician, and one in the ambulatory blood pressure monitoring (ABPM) unit, performed by a trained nurse, prior to the initiation of ABPM (pre-ABPM blood pressure). In normotensive and hypertensive subjects of both sexes, the mean office systolic blood pressure (SBP) was lower than the mean pre-ABPM SBP, and the mean office diastolic blood pressure (DBP) was lower than the mean pre-ABPM DBP. In normotensive participants, the mean pre-ABPM SBP/DBP was lower than the mean ABPM SBP/DBP while awake, the mean ABPM SBP/DBP during sleep being lower than the mean ABPM SBP/DBP values while awake and the mean pre-ABPM SBP/DBP. No statistical difference was demonstrated between the mean office SBP and the mean ABPM SBP during sleep, the mean ABPM DBP during sleep being lower than the mean office DBP. The hypertensive adolescents presented a blood pressure profile similar to that of the normotensive group, albeit shifted upwards, with no significant difference between the mean pre-ABPM SBP and the mean ABPM SBP while awake but a higher mean pre-ABPM DBP than mean ABPM DBP while awake. This study suggests that, by evaluating the casual blood pressure in different environment/observer situations, the power of casual blood pressure to predict inadequate blood pressure control, manifested as abnormal ABPM parameters, can be enhanced. Our data indicate ABPM to be the method of choice for the early diagnosis and adequate follow-up of adolescent hypertension.

aPediatric Nephrology and bAdolescent Units, Children's Hospital, cHypertension Unit, Nephrology Division, General Hospital of the University of São Paulo School of Medicine, São Paulo, Brazil

Correspondence and requests for reprints to Vera H. Koch MD, R. das Mangabeiras 91/81, 01233-010 São Paulo-SP, Brazil. Tel: +55 11 8250321; fax +55 11 3824 9672; e-mail: vkoch@zaz.com.br

Received 23 February 2000

Revised 2 June 2000

Accepted 4 October 2000

© 2000 Lippincott Williams & Wilkins, Inc.