Twenty‐four‐hour ambulatory blood pressure profiles in liver transplant recipients

Abstract

Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has proven to have better reproducibility than office blood pressure (BP) and is increasingly used for the study of hypertension in children and adolescents. The aim of our study was to assess 24-h BP profiles and to compare the results of office BP measurements with ABPM in stable liver transplant recipients transplanted before the age of 18 yr. ABPM was performed in 29 patients (nine males, 20 females), aged 3.9-24.8 yr (median 10.8 yr). The investigation was conducted 1.1-11.5 yr (median 5.1 yr) following transplantation. ABPM confirmed hypertension in one out of three office hypertensive patients. Seven patients (24%), whose office BP recordings were within the normotensive range, were reclassified as hypertensive. Non-dippers (n = 17), arbitrarily defined as patients with less than 10% nocturnal fall in BP, were similarly distributed among patients with ambulatory normotension and ambulatory hypertension (chi(2), p = 0.79). In addition, non-dippers showed a negative correlation between 24-h total urinary albumin excretion and both systolic and diastolic nocturnal decline in BP (Rho = -0.48, p < 0.05 and Rho = -0.86, p < 0.01, respectively). Our study found office BP readings to be poorly representative of 24-h BP profile. Larger studies are needed to confirm our observations as well as to determine whether routine BP measurements in the follow-up of paediatric liver transplant recipients should be based solely on office BP.

Posttransplant metabolic syndrome in children and adolescents after liver transplantation: A systematic review

“…Fifty percent of the 16 studies included in this review relied on the use of antihypertensive medications as evidence of hypertension, and 13% provided no definition 22, 23, 27, 33‐45. Estimates of the prevalence of hypertension from these studies vary from 4% to 100% (Table 2).…”

Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment

“…Rule out masked hypertension 132,133 Renal transplant recipient Evaluate for nocturnal hypertension 134 Polycystic ovary disease gene carriers…”

Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio

“…ND attenuation was associated with the presence of other cardiovascular risk factors (obesity and lower HDL-c) and also with a higher frequency of lesion in target-organ. Studies on the prevalence of cardiovascular and cerebral events varies greatly in the specific literature (Table 5), reaching a frequency of 37.5 to 64.2% [11][12][13][14][15][16][17][18][19][20][21] under several factors' influence, like the definition of sleep and vigil periods 22 .…”