Ambulatory blood pressure monitoring in healthy children with parental hypertension

Abstract

The aim of this study was to compare ambulatory blood pressure monitoring (ABPM) parameters in offspring with at least one hypertensive parent (HP) to offspring with normotensive parents (NP) and to determine whether gender of parent or child might influence the association between parental hypertension and blood pressure (BP). Eighty-nine healthy children (mean age 11.1 +/- 3.9 years) with HP and 90 controls (mean age 10.5 +/- 3.1 years) with NP were recruited. Age, gender, and height did not differ between the two groups, whereas children of HP had higher weight, body mass index (BMI), and waist circumference compared with healthy controls. No difference was found in casual BP between the two groups. In contrast, during ABPM daytime and nighttime mean systolic and diastolic BP and mean arterial pressure (MAP) standard deviation scores (SDS) were significantly elevated in children with HP. The mean percentage of nocturnal BP decline (dipping) was not significantly different between the two groups. Children with hypertensive mothers had higher daytime systolic and MAP SDS than controls; no such difference was detected for children with hypertensive fathers. Daytime systolic and MAP SDS were significantly elevated in boys with HP compared with boys with NP but failed to be significant in girls. Multiple linear regression analysis showed that parental history of hypertension (B = 0.29) and BMI (B = 0.03) were independently correlated with increase of daytime MAP SDS. Early changes in ambulatory BP parameters were present in healthy children of HP. BP in HP offspring was influenced by the gender of the affected parent and the offspring.

Circadian blood pressure rhythm in normotensive offspring of hypertensive parents

“…In the study by Ravogli et al [12], involving young adults, and in the study by Alpay et al [15], involving children with a positive family history of hypertension, nocturnal and average SBP values were significantly higher in these populations compared to those with a negative family history for hypertension. In these studies, the authors emphasized the fact that in healthy children with a positive family history of hypertension, ABPM allows detection of early changes.…”

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

“…Family history of HTN or CV disease may identify children and adolescents with essential HTN, but history of hereditary diseases associated with secondary forms of HTN should also be relevant (1,37). Parental history of HTN has been associated with masked HTN, early TOD, changes in central and peripheral hemodynamics, and can guide further evaluation (79,(93)(94)(95). A complete clinical history assessment may include information summaraised in Table 4.2.1.…”

Importance of Ambulatory Blood Pressure Monitoring in Adolescent Hypertension

“…Recent studies of healthy adolescents have shown that if either parent is hypertensive, their own ABPM data are also higher both in terms of daytime and nighttime systolic and diastolic BPs [51] . Parental BP is a strong predictor of their children's BP in the future.…”