Predictors of Higher Blood Pressure in a Clinical Setting in Normotensive Children: A Prospective Study

Abstract

This study was designed to assess the predictors of a higher blood pressure (BP) in a clinical setting in a prospective cohort of normotensive children recruited in an outpatient pediatric clinical setting in Southern Brazil. The study evaluated 443 children 3–12 years of age. If the mean value of BP was greater than the 95th percentile for age, sex and height in the medical setting, children were scheduled to other two evaluations at home. The systolic BP percentile in the clinical consultation was associated with BMI and birth weight. The diastolic BP in the clinical consultation was associated with birth weight, age, and BMI. Weight excess, low birth weight and younger age were associated with a higher BP in normotensive children seen in a clinical setting. To our knowledge, this is the first study to describe the association between lower birth weight and a greater BP response to medical consultation. Our finding suggests that the tendency to higher white-coat effect is determined, at least to some extent, in intrauterine life.

Correlates of elevated blood pressure in healthy children: a systematic review

“…In all of these, higher adiposity was associated with higher BP or odds of hypertension. This association was observed in cross‐sectional studies ( n = 46) , and also in prospective studies ( n = 9) . Results were mostly consistent across study type (i.e.…”

“…Age, as a continuous variable, was observed to be significantly associated with SBP and/or DBP in cross‐sectional studies , with SBP longitudinally and with hypertension in cross‐sectional studies . However, the direction of the association was not consistent across all studies, with most studies reporting positive associations, yet with two cross‐sectional studies reporting inverse associations .…”

“…In most studies, birthweight was inversely associated with SBP, DBP or both over a time period . Conversely, two studies reported positive associations between birthweight and BP.…”