Diurnal blood pressure patterns in normotensive and hypertensive children and adolescents

Abstract

As abnormalities in diurnal ambulatory blood pressure pared to normotensive subjects (17.1 ؎ 6.7 vs 14.6 ؎ 7.1 mm Hg; unadjusted mean ؎ s.d., P ‫؍‬ 0.022). Normo-(BP) have been associated with hypertensive target organ damage in adults, we investigated the diurnal systensive and hypertensive groups did not differ in nocturnal DBP fall or SBP or DBP night-day ratio. Race tolic BP (SBP) and diastolic BP (DBP) patterns of 54 normotensive children, age 13.4 ؎ 3.0 years, and 45 appeared to influence the diurnal BP pattern as black subjects had less nocturnal SBP fall (12.9 ؎ 6.9 vs untreated borderline and mildly hypertensive children, age 14.4 ؎ 2.6 years. Subjects wore the SpaceLabs 17.1 ؎ 6.5 mm Hg; P Ͻ 0.005) and a higher night-day SBP ratio (90.1 ؎ 5.3 vs 86.7 ؎ 4.6%; P Ͻ 0.005) than 90207 ambulatory BP monitor for 24 h. BP was measured q 15 min from 08.00-21.00 h then q 30 min from white subjects.In conclusion, hypertensive children and ado-21.00-08.00 h. Nocturnal BP fall, the night-day ratio and cusum derived measures were calculated from timelescents have a similar diurnal BP pattern as their normotensive counterparts, except that the entire BP proweighted daytime and night-time SBP and DBP. The groups were compared using analysis of covariance file is shifted upward with a greater absolute fall in SBP at night. Race also appears to influence the diurnal BP with adjustment for age, race, gender and body mass index. The influence of age, gender and race on the diurprofile of normotensive and hypertensive children and adolescents. nal BP profile was also examined.Nocturnal SBP fall was greater in hypertensive com-

Differing Temporal Patterns of Onset in Subgroups of Patients With Intracerebral Hemorrhage

“…Hypertensive subjects may be particularly vulnerable in the morning because although they have circadian blood pressure variations similar to those of normotensive subjects, they have higher average blood pressure than the latter. 21,23,27,28 Among the traditional risk factors, only age seemed significantly related to the diurnal variations in ICH onset; however, we found that this was due to the fact that younger patients had almost exclusively secondary hemorrhages.…”

“…7,[11][12][13][14][15][16] Seasonal and diurnal blood pressure variations have been considered a possible explanation for these patterns of onset. 3,5,[7][8][9][12][13][14][15] The plausibility of this mechanism is supported by the fact that blood pressure is the most powerful risk factor for ICH and has seasonal [17][18][19][20] and circadian [21][22][23][24][25][26][27][28] variations that essentially parallel seasonal and circadian variations in ICH onset.…”

Race and Diurnal Blood Pressure Patterns

“…Although blacks had higher average ABPM values, the difference between blacks and whites was greater during sleep than while awake. 26 Belsha et al 23 found less nocturnal fall in SBP in blacks among children from hypertensive families in Little Rock, Ark.…”

“…Because only 2 studies involving non-American blacks made comparisons to American whites, 11,21 the country of origin of the white comparison has not been taken into account. Although differences in diurnal patterns of blood pressure have been reported between normotensives and hypertensives, across gender, and among other ethnic groups, 23,34,24 for the purposes of this meta-analysis, an effect size was calculated for overall differences between ethnic groups for each black/white comparison, because information about gender and hypertension status is not provided for participants in all studies.…”

I Diretrizes para o Uso da Monitorização Residencial da Pressão Arterial

“…Belsha e cols. 9 compararam, através da monitorização ambulatorial da pressão arterial, o perfil de pressão arterial de vigília e sono de crianças e adolescentes normotensos e hipertensos, demonstrando que os pacientes hipertensos apresentam médias pressóricas mais elevadas, com perfil pressórico de 24h semelhante aos seus pares normotensos. Não existem critérios estabelecidos de normalidade para as variáveis obtidas.…”