Twenty-four-hour ambulatory blood pressure monitoring in infants and toddlers

Abstract

During the past several years, 24-hour (24-h) ambulatory blood pressure monitoring (ABPM) has become a useful tool for the diagnosis and management of children and adolescents with elevated blood pressure (BP). Some reports have also provided blood pressure nomograms for particular devices. However, there are very few reports of the use of this method in very young children. In our study we investigated the applicability of ABPM in 97 healthy infants and toddlers, aged from 2 to 30 months. A satisfactory ABPM profile was obtained in 86.6% of the children, with an average of 75.0% satisfactory BP recordings. The mean +/- SD systolic and diastolic BP of healthy infants and toddlers was 99+/-12/62+/-12 mmHg during the daytime and 95+/-11/57+/-10 mmHg during the night, with no gender difference being observed. The 24-h mean +/- SD systolic and diastolic BP, which may be a more appropriate measure of BP in this particular age group, was found to be 97+/-12/59+/-11 mmHg. We also confirmed the increase in systolic and diastolic BP with increased height (length). There was only a slight nocturnal decrease in BP. We conclude that this method is applicable for the assessment of blood pressure in very young children.

Agreement on reporting of ambulatory blood pressure monitoring in children

“…ABPM is a valuable tool for use in children of all ages with suspected hypertension [2,16], but we have shown that interpretation of ABP records may be influenced by a degree of subjectivity leading to differing conclusions. This variability in reporting could be reduced by consensus regarding standardised interpretation; however, until further research provides more evidence, we suggest that the guidelines of Lurbe, Sorof and Daniels [11] be adopted.…”

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

“…112 Varda and Gregoric studied 97 infants and toddlers aged 2 to 30 months. 78 They noted no differences in ABPM values in relation to gender. There was also a smaller degree of nighttime dipping.…”

“…One limitation noted was that the smallest available cuff was too large for some infants. 78 Gellermann et al obtained useable recordings in 77% of 101 children 3 to 6 years of age with and without renal disease and/or hypertension, with the ability to obtain useable recordings improving with age. 79 One half of the children diagnosed with high BP in the clinic setting were actually found to have normal ABPM, 80 emphasizing the use of ABPM in the diagnosis of hypertension.…”

Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children

“…Even with these apparent limitations in equipment, ABP monitoring has been used successfully in many different centers, even in children as young as 2 years of age [8]. The ability to obtain complete recordings varies, however, depending on the population.…”