Related Experiment Videos

White-coat hypertension and masked hypertension in children

George S Stergiou1, Nikolaos J Yiannes, Vayia C Rarra

  • 1Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece. gstergi@med.uoa.gr

Blood Pressure Monitoring
|February 24, 2006
PubMed

Insights

Ambulatory blood pressure monitoring helps detect white-coat and masked hypertension in children. Masked hypertension, more common in healthy children, is linked to heart damage and requires monitoring or treatment.

Area of Science:

  • Pediatric Nephrology and Cardiology
  • Clinical Hypertension Research

Background:

  • Conventional office blood pressure measurements may miss cases of white-coat hypertension and masked hypertension.
  • Ambulatory blood pressure monitoring (ABPM) offers a more comprehensive assessment of blood pressure patterns.
  • These hypertensive variants are increasingly recognized in pediatric populations.

Purpose of the Study:

  • To evaluate the prevalence of white-coat hypertension and masked hypertension in children.
  • To assess the association of these conditions with target organ damage, particularly left ventricular mass.
  • To determine the clinical implications for follow-up and management in pediatric hypertension.

Main Methods:

  • Utilized ambulatory blood pressure monitoring (ABPM) alongside conventional office measurements.
  • Studied children referred for elevated blood pressure and a cohort of healthy children.
  • Echocardiography was employed to assess target organ damage, specifically left ventricular mass.

Main Results:

  • White-coat hypertension and masked hypertension each affect 10-15% of children referred for elevated blood pressure.
  • In healthy children, masked hypertension is more prevalent than white-coat hypertension or sustained hypertension.
  • Masked hypertension, unlike white-coat hypertension, is associated with increased left ventricular mass in children.

Conclusions:

  • ABPM is crucial for diagnosing white-coat and masked hypertension in children.
  • Masked hypertension in children poses a risk for target organ damage and warrants close monitoring.
  • Persistent masked hypertension or evidence of organ damage necessitates antihypertensive treatment considerations.

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Alterations in Blood Pressure01:30

Alterations in Blood Pressure

Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Blood Pressure01:30

Blood Pressure

Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...