Prospective evaluation of ambulatory blood pressure monitoring parameters in children with white coat hypertension

Background Isolated office hypertension, so called white-coat hypertension is a common cardiovascular condition in the general population. The prevalence of white-coat hypertension is about 22-45% of children with elevated casual readings. There are no data about long term observations of this kind elevated blood pressure in children. The aim of this study was evaluation of ambulatory blood pressure monitoring measurements in children and adolescents with white-coat hypertension and try to establish whether this condition is a risk factor for persistent hypertension in these patients. Material and methods The study population consisted of 49 patients mean age 15 years (+/- 2,3) - 12 girls and 35 boys. After a period of 2 years - average 660 days (SD +/- 211) we reexamined 35 of them - 10 girls and 25 boys, prospectively. ambulatory blood pressure monitoring was performed and two readings was compared for each patient. Results were statistically analyzed. Results We observed significant elevation of mean 24-h blood pressure in the second ambulatory blood pressure monitoring. 34% of children with white-coat hypertension exceeded 95th percentile and were regarded as hypertensive. Significant difference was noted between the first and the second systolic blood pressure load measurements which rose - from 17,7% to 31,2% during daytime and from 16,2% to 36,7% during nighttime. There wasn't statistical difference in 24-h blood pressure profile in children during the 2 years observation. Conclusions Isolated office hypertension seems to be a risk factor for developing persistent hypertension in children. It is recommended that blood pressure monitoring be carried out periodically in children with white-coat hypertension.