This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (23)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Flynn, J. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Flynn, J. T.
Related Collections
Right arrow Heart & Blood Vessels
PEDIATRICS Vol. 110 No. 1 July 2002, pp. 89-93

Differentiation Between Primary and Secondary Hypertension in Children Using Ambulatory Blood Pressure Monitoring

Joseph T. Flynn, MD

From the Division of Pediatric Nephrology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York

Objective. To determine whether ambulatory blood pressure monitoring (ABPM) can help differentiate children with secondary hypertension from those with primary hypertension.

Methods. Ninety-seven ABPM studies obtained from 85 children followed in a pediatric hypertension clinic were analyzed. Forty studies were performed in patients with primary hypertension, and 57 studies were performed in patients with secondary hypertension. Mean patient age was 13.8 ± 3.5 [mean ± standard deviation] years, range 4 to 19.7 years; patients with secondary hypertension were younger and had lower body mass index than patients with primary hypertension.

Results. Daytime diastolic and nocturnal systolic blood pressure (BP) loads, defined as the percentage of readings greater than a threshold value, were significantly greater in patients with secondary hypertension compared with patients with primary hypertension. A daytime diastolic BP load of ≥25% and/or a nocturnal systolic BP load of ≥50% was highly specific for secondary hypertension.

Conclusions. Secondary hypertension in childhood is characterized by daytime diastolic BP elevation and nocturnal systolic BP elevation. This pattern of hypertension on ABPM may be a clue to underlying renal or other organ system pathology in children being evaluated for suspected hypertension and could help to identify children who require more detailed evaluation to determine the cause of their hypertension.

Key Words: children • hypertension • ambulatory blood pressure monitoring • diagnostic testing

Abbreviations: ABPM, ambulatory blood pressure monitoring • BP, blood pressure • BMI, body mass index


Received for publication Jun 19, 2001; Accepted Jan 22, 2002.




This article has been cited by other articles:


Home page
ChestHome page
L. C.K. Leung, D. K. Ng, M. W. Lau, C.-h. Chan, K.-l. Kwok, P.-y. Chow, and J. M.Y. Cheung
Twenty-Four-Hour Ambulatory BP in Snoring Children With Obstructive Sleep Apnea Syndrome.
Chest, October 1, 2006; 130(4): 1009 - 1017.
[Abstract] [Full Text] [PDF]


Home page
CLIN PEDIATRHome page
S. Rowan, H. Adrogues, A. Mathur, and D. Kamat
Pediatric Hypertension: A Review for the Primary Care Provider
Clinical Pediatrics, May 1, 2005; 44(4): 289 - 296.
[PDF]


Home page
HypertensionHome page
J. M. Sorof, J. Turner, D. S. Martin, K. Garcia, Z. Garami, A. V. Alexandrov, F. Wan, and R. J. Portman
Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening
Hypertension, February 1, 2004; 43(2): 214 - 218.
[Abstract] [Full Text] [PDF]


Home page
JWatch PediatricsHome page
Ambulatory Blood Pressure Monitoring Is Useful for Evaluating Hypertensive Children
Journal Watch Pediatrics and Adolescent Medicine, August 12, 2002; 2002(812): 9 - 9.
[Full Text]