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Published on: April 29, 2013

White coat hypertension in children: not rare and not benign?

Mieczyslaw Litwin1, Anna Niemirska, Marcel Ruzicka

  • 1Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland; Department of Research, The Children's Memorial Health Institute, Warsaw, Poland.

Journal of the American Society of Hypertension : JASH
|April 23, 2010
PubMed

Insights

White coat hypertension (WCH) in children shows target organ damage comparable to essential hypertension (HTN). This finding highlights the importance of monitoring WCH in pediatric patients to prevent long-term cardiovascular risks.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Cardiovascular Health

Background:

  • The clinical significance of white coat hypertension (WCH) in children is not well-established.
  • Essential hypertension (HTN) in children is associated with target organ damage (TOD).

Purpose of the Study:

  • To evaluate target organ damage (TOD) in children diagnosed with essential hypertension (HTN) and white coat hypertension (WCH).

Main Methods:

  • Retrospective analysis of 183 untreated children (5-19 years) referred for hypertension assessment.
  • Evaluated body mass index (BMI), ambulatory blood pressure monitoring (ABPM), left ventricular mass index (LVMi), and carotid intima media thickness (CIMT) in a subset.
  • WCH defined by normal mean arterial pressure (MAP), MAP load, and MAP day/night ratio.

Main Results:

  • White coat hypertension (WCH) was identified in 29.5% of referred children.
  • Left ventricular mass index (LVMi) and carotid intima media thickness (CIMT) were comparable between children with HTN and WCH.
  • A significant percentage of children in both HTN (40%) and WCH (36%) groups exhibited elevated LVMi, exceeding the 95th percentile.

Conclusions:

  • White coat hypertension (WCH) in children is associated with target organ damage comparable to essential hypertension (HTN).
  • Despite lower blood pressure and better BP dipping patterns, WCH patients showed similar TOD to HTN patients.
  • These findings underscore the need for vigilant monitoring of WCH in pediatric populations.

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