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Study results call into question the utility of
testing blood pressure load–the proportion of elevated blood pressure readings
detected over 24 hours–for diagnosing hypertension in children.
Results from a new study provide
insights on evaluating high blood pressure in children. The findings appear in
an upcoming issue of CJASN.
Diagnostic workup for hypertension
in children may include wearing a device that monitors blood pressure over 24
hours. Blood pressure load–the proportion of elevated blood pressure readings
detected over 24 hours–is used in addition to average blood pressure as part of
the criteria for diagnosing hypertension in children. Use of blood pressure
load in everyday practice may lead to confusion in scenarios where a child has
elevated blood pressure load but normal average blood pressure, however, and
it’s unclear how a high blood pressure load (with normal average blood pressure)
affects long-term health.
To provide insight, Jason Lee, MD
(University of California, San Francisco) and his colleagues studied 533
children with chronic kidney disease who underwent 24-hour blood pressure
monitoring, along with tests related to kidney and heart health over several
years. Based on 24-hour blood pressure data, the team grouped children as
having normal blood pressure, high blood pressure load but without high average
blood pressure, and high average blood pressure.
One-quarter of the children had high
blood pressure load. Having high blood pressure load by itself was not
associated with higher risks of developing kidney failure or a condition called
left ventricular hypertrophy (thickening of the heart), which can develop in
response high blood pressure.
“Our data suggest that the
proportion of readings on a 24-hour blood pressure test that are high may not
provide additional insight beyond the average blood pressure values surrounding
a child’s risk for developing cardiac disease or worsening kidney disease,”
said Dr. Lee. “However, having a high average blood pressure on a 24-hour blood
pressure test does strongly predict a child’s cardiac and kidney disease risk.”
Journal
article: https://cjasn.asnjournals.org/content/early/2020/03/10/CJN.10130819
More info: https://www.asn-online.org/
Source: https://myfusimotors.com/2020/03/16/diagnosing-hypertension-in-children/
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