PEDIATRICS Vol. 87 No. 1 January 1991, pp. 94-100
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Ambulatory Blood Pressure Patterns in Children and Adolescents: Influence of Renin-Sodium Profiles

Gregory A. Harshfield PhD1, Derrick A. Pulliam BS1, Bruce S. Alpert MD1, F. Bruder Stapleton MD1, Elaine S. Willey PhD1, and Grant W. Somes PhD1

1 From the Departments of Pediatrics and Biostatistics and Epidemiology, University of Tennessee, Memphis, and the Clinical Research Center, LeBonheur Children's Medical Center, Memphis, Tennessee

A renin-sodium nomogram for normotensive children and adolescents was developed at our institution. The ambulatory blood pressure patterns of subjects classified by the nomogram were then compared. A biracial sample of 159 children and adolescents were classified as having a low, intermediate, or high renin-sodium profile based on the relationship between their plasma renin activity and 24-hour urinary sodium excretion. Casual (106/58 vs 107/61 vs 106/62 mm Hg) and awake (116/69 vs 117/69 vs 116/70 mm Hg) blood pressure values were comparable among subjects with low, intermediate, and high renin-sodium profiles. Subjects with high renin-sodium profiles, however, had a smaller decline in systolic blood pressure with sleep than did subjects with low renin-sodium profiles (7 vs 11 mm Hg; P < .04), and higher diastolic blood pressure readings during sleep than subjects with intermediate renin-sodium profiles (65 vs 62 mm Hg; P < .05). Subjects with high renin-sodium profiles also had greater variance of diastolic blood pressure readings during sleep than either subjects with low renin-sodium profiles (P < .01) or those with intermediate renin-sodium profiles (P < .02). The blunted nocturnal decline and increased nocturnal variance of blood pressure among subjects with high renin-sodium profiles may be a marker or mechanism for the future development of essential hypertension.

Key Words: ambulatory blood pressure • renin-sodium profile • adolescent blood pressure • hypertension

Submitted on February 5, 1990
Accepted on April 10, 1990




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[Abstract] [Full Text]