Masked hypertension in extremely preterm adolescents

Area of Science:

• Pediatrics
• Cardiovascular Health
• Neonatal Research

Background:

• Extremely preterm (EPT) or extremely low birthweight (ELBW) individuals face elevated risks for hypertension and cardiovascular disease.
• Monitoring blood pressure (BP) in these individuals is crucial for early detection and management of cardiovascular risks.

Purpose of the Study:

• To compare office BP measurements with 24-hour ambulatory BP measurement (ABP) in EPT/ELBW individuals and term controls at age 18.
• To determine the sensitivity and specificity of office BP in identifying masked hypertension (elevated 24-hour ABP) in EPT/ELBW survivors.

Main Methods:

• Recruited EPT/ELBW individuals and matched term controls born in Victoria, Australia (1991-1992).
• Measured office BP and ABP in a subset of participants at age 18, with researchers blinded to birth status.
• Established optimal office BP thresholds for predicting masked hypertension.

Main Results:

• EPT/ELBW individuals exhibited higher mean BP measurements at age 18 compared to controls.
• High rates of masked systolic hypertension were observed in both EPT/ELBW (43.3%) and control (36.6%) groups.
• Office systolic BP ≥122.5 mmHg and diastolic BP ≥75.5 mmHg showed good sensitivity and specificity for predicting masked hypertension in EPT/ELBW individuals.

Conclusions:

• At 18 years, EPT/ELBW survivors have elevated systolic and diastolic BP compared to term-born controls.
• Office BP measurements appear adequate for screening masked hypertension in EPT/ELBW survivors.
• Further research is necessary to refine ABP thresholds for masked hypertension diagnosis in young Australians.