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Altered cardiovascular rhythmicity in children with white coat and ambulatory hypertension

Mieczysław Litwin1, Giacomo D Simonetti, Anna Niemirska

  • 1The Children's Memorial Health Institute, 04-730 Warsaw, Poland. m.litwin@czd.pl

Pediatric Research
|December 25, 2009
PubMed

Insights

Children with hypertension show abnormal cardiovascular rhythms, including reduced 24-hour blood pressure (BP) rhythm amplitudes and increased prevalence of non-dipping. White coat hypertension (WCH) cases displayed intermediate abnormalities.

Area of Science:

  • Pediatrics
  • Cardiology
  • Hypertension Research

Background:

  • Adults with ambulatory hypertension or white coat hypertension (WCH) exhibit altered cardiovascular rhythms.
  • Understanding these rhythms in children is crucial for early detection and management.

Purpose of the Study:

  • To investigate and compare cardiovascular rhythm patterns in hypertensive children, children with WCH, and healthy controls.
  • To analyze 24-hour ambulatory blood pressure (BP) profiles using Fourier analysis.

Main Methods:

  • Fourier analysis of 24-hour ambulatory BP monitoring data.
  • Comparison of day/night mean arterial pressure ratio, dipping status, and rhythm prevalence/amplitude/acrophase across three groups: hypertensive children (n=129), WCH children (n=54), and healthy controls (n=146).

Main Results:

  • Hypertensive children and those with WCH had a lower day/night mean arterial pressure ratio compared to controls.
  • A higher prevalence of non-dipping was observed in hypertensive children (64%) and WCH (74%) versus controls (85%).
  • Reduced amplitudes and delayed acrophases for 24-, 12-, 8-, and 6-hour BP rhythms were noted in hypertensive and WCH groups compared to controls.

Conclusions:

  • Hypertensive children demonstrate abnormal cardiovascular rhythmicity, characterized by reduced BP rhythm amplitudes and increased non-dipping.
  • Children with WCH present intermediate cardiovascular rhythm abnormalities between healthy children and those with sustained ambulatory hypertension.
  • These findings highlight the importance of assessing cardiovascular rhythms in pediatric hypertension and WCH.

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