Comparison of ambulatory blood pressure monitoring and office blood pressure measurements in obese children and adolescents

The study protocol was conducted in accordance with the Declaration of Helsinki and approved by the Antalya Research and Education Hospital Ethics Committee. Written informed consent was provided by the patient family before the start of study. This manuscript, or any part of it, has not been previously published; nor is it under consideration for publication elsewhere.

Abstract

Background: Obesity in adults has been related to hypertension and abnormal nocturnal dipping of blood pressure, which are associated with poor cardiovascular and renal outcomes. Here, we aimed to resolve the relationship between the degree of obesity, the severity of hypertension and dipping status on ambulatory blood pressure in obese children.

Methods: A total 72 patients with primary obesity aged 7 to 18 years (mean: 13.48 ± 3.25) were selected. Patients were divided into three groups based on body mass index (BMİ) Z-score. Diagnosis and staging of ambulatory hypertension based on 24-h blood pressure measurements, obtained from ambulatory blood pressure monitoring.

Results: Based on our ambulatory blood pressure data, 35 patients (48.6%) had hypertension, 7 (20%) had ambulatory prehypertension, 21 (60%) had hypertension, and 7 patients (20%) had severe ambulatory hypertension. There was a significant relationship between severity of hypertension and the degree of obesity (p < 0.05). Thirty-one patients (88.6%) had isolated nighttime hypertension, and 53 patients (73.6%) were non-dippers. All systolic blood pressure results and loads were similar between groups. Diastolic and mean arterial blood pressure levels during the night, diastolic blood pressure loads, and heart rate during the day were significantly higher in Group 3 (p < 0.05). Nocturnal non-dipping was not associated with severity of obesity.

Conclusion: Obesity was associated with severity of hypertension, higher diastolic blood pressure at night, mean arterial pressure at night, diastolic blood pressure loads and heart rate at day. Increase in BMI Z-score does not a significant impact on daytime blood pressure and nocturnal dipping status.

Keywords:

• Ambulatory blood pressure
• body mass index
• hypertension
• obesity

Acknowledgments

We thank the Assoc. Prof. Mesut Parlak and M.D. Pınar Erturgut for patients follow-up in policlinic.

Notes

The study protocol was conducted in accordance with the Declaration of Helsinki and approved by the Antalya Research and Education Hospital Ethics Committee. Written informed consent was provided by the patient family before the start of study. This manuscript, or any part of it, has not been previously published; nor is it under consideration for publication elsewhere.