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The impact of the degree of obesity on the discrepancies between office and ambulatory blood pressure values in youth

Lurbe, Empara; Invitti, Ceciliab; Torro, Isabela; Maronati, Albertob; Aguilar, Franciscoa; Sartorio, Giuseppeb; Redon, Josepc; Parati, Gianfrancod

doi: 10.1097/01.hjh.0000239291.32883.e3
Original papers: Blood pressure measurement

Objectives Obesity is an increasingly frequent problem among children and adolescents, and may lead to blood pressure (BP) increase. The aim of the present study was to assess the prevalence of hypertension, white-coat and masked hypertension in obese adolescents making systematic use of both office BP and 24-h ambulatory BP measurement. The impact of different degrees of obesity on BP and heart rate variability was also investigated.

Methods Office and ambulatory BP were obtained in 285 overweight and obese Caucasian adolescents (11–18 years old) and in 180 age- and sex-matched controls. The extent of obesity was quantified using body mass index z score.

Results A significant positive relationship between body mass index z score and both office and ambulatory systolic BP was found after adjusting for age and height in both boys and girls. Obese youths had not only higher BP levels, but also higher BP variability compared with controls. Among obese youths, 20.8% had abnormal BP conditions, 6.6% were white-coat hypertensives, 9.2% were masked hypertensives and 5% were sustained hypertensives.

Conclusions The prevalence of these abnormal BP conditions, which can be identified thanks to ambulatory BP monitoring, further emphasizes the usefulness of this diagnostic tool in obese youths.

aPediatric Nephrology and Cardiovascular Risk Unit, Consorcio Hospital General, University of Valencia, Recava, Spain

bInstituto Auxologico Italiano, Milan, Italy

cHypertension Clinic, Hospital Clinico, University of Valencia, Recava, Spain

dDepartment of Clinical Medicine, Prevention and Applied Biotechnology, University of Milano-Bicocca; Cardiology II, S. Luca Hospital, Istituto Auxologico Italiano, Milan, Italy

Received 28 January, 2006

Revised 1 March, 2006

Accepted 14 March, 2006

Correspondence and requests for reprints to Empar Lurbe, Pediatric Nephrology Unit, Department of Pediatrics, Consorcio Hospital General, University of Valencia, Avda Tres Cruces s/n, 46014 Valencia, Spain fax: +34 96 3862647; e-mail: empar.lurbe@uv.es

Sponsorship: The Instituto de Salud Carlos III, Ministry of Health, Madrid, Spain (RECAVA C03/01) funded the study in Spain. The study was presented as an Abstract to the XV Meeting of the European Society of Hypertension, Milan June 2005.

© 2006 Lippincott Williams & Wilkins, Inc.