Nocturnal blood pressure non‐dipping is prevalent in severely obese, prepubertal and early pubertal children

Westerståhl, Maria; Kallerman, Pernilla Hedvall; Hagman, Emilia; Ek, Anna; Rössner, S; Marcus, Claude

doi:10.1111/apa.12479

Cited by 28 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, our cohort mirrors the results of two prior studies which suggested that SCA patients have a higher prevalence of nocturnal hypertension and lack of nocturnal dipping in pediatric SCA [21, 22]. The prevalence of non-dipping in this SCA study (70 % abnormal SBP dipping and 50 % abnormal DBP dipping) is higher than obese pediatric patients (42 % and 17 % abnormal SBP and DBP dipping) or patients with diabetes (20-40 % abnormal dipping) [36-38]. Finally, our study suggests that nocturnal hypertension and abnormal nocturnal dipping have strong associations with a lower eGFR (33 mL/min/1.73m 2 lower for patients with nocturnal hypertension) and may be, as well-established in several other disease states, a strong predictor of adverse renal and cardiovascular outcomes.…”

Section: Discussionsupporting

confidence: 85%

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

et al. 2017

View full text Add to dashboard Cite

Background Patients with Sickle Cell Anemia (SCA) have an increased prevalence of nephropathy and mortality from chronic kidney disease (CKD). Methods We evaluated the association of hyperuricemia and nocturnal hypertension with lower estimated glomerular filtration rate (eGFR) by cystatin-C among patients 10-21 years old with HbSS or SB0 thalassemia during a non-acute clinic visit. eGFR was obtained in 83 participants, uric acid in 81, and 24 hour ambulatory blood pressure monitoring (ABPM) was performed in 44 participants. Vital signs, CBC, CMP, LDH, medications, and urine microalbumin/creatinine were measured. Hyperuricemia was defined as a uric acid level ≥5.5 mg/dL. Nocturnal hypertension was defined as >25 % of nocturnal readings >95th percentile according to norms established by the American Heart Association Statement on ABPM in children and adolescents. Results The mean eGFR was statistically significantly lower among patients with hyperuricemia than with normal uric acid levels (143 vs 161 mL/min/1.73m2, respectively). Fourteen of 44 (32 %) participants had systolic nocturnal hypertension and 12 of 44 (27 %) had diastolic nocturnal hypertension. The mean eGFR was statistically significantly lower among participants with nocturnal systolic and diastolic hypertension than normal nocturnal blood pressure. In a regression model, nocturnal hypertension and hyperuricemia were associated with a lower eGFR. Conclusion Two risk factors for CKD, nocturnal hypertension and hyperuricemia, were associated with lower eGFR in older children and adolescent patients with SCA, and warrant long-term studies of their association with progression to CKD in this population.

show abstract

Section: Discussionsupporting

confidence: 85%

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In another study in adults, a specific antihypertensive treatment reduced both ABPM and inflammatory and oxidative biomarkers, including MPO . However, previous studies in young children failed to find an association between dipping and insulin resistance . Accordingly, in our study, we found no association between glucose, insulin or HOMA‐IR levels and the dipping pattern (data not shown).…”

Section: Discussioncontrasting

confidence: 71%

Association of myeloperoxidase levels with cardiometabolic factors and renal function in prepubertal children

Correia-Costa

Sousa

Morato

et al. 2015

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Obesity is also associated with a lack of circadian variability of BP, 29,30 with up to 50% of children who have obesity not experiencing the expected nocturnal BP dip. [31][32][33] Studies have shown that childhood obesity is also related to the development of future HTN. 22 Elevated BMI as early as infancy is associated with higher future BP.…”

Section: 2cmentioning

confidence: 99%

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

et al. 2017

View full text Add to dashboard Cite

These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.

show abstract

Nocturnal blood pressure non‐dipping is prevalent in severely obese, prepubertal and early pubertal children

Cited by 28 publications

References 27 publications

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

Evaluating risk factors for chronic kidney disease in pediatric patients with sickle cell anemia

Association of myeloperoxidase levels with cardiometabolic factors and renal function in prepubertal children

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Contact Info

Product

Resources

About