Stabouli Stella, Kotsis Vasilios, Toumanidis Savvas, Papamichael Christos, Constantopoulos Andreas, Zakopoulos Nikos
Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, National and Kapodestrial University of Athens, Greece.
Pediatr Nephrol. 2005 Aug;20(8):1151-5. doi: 10.1007/s00467-005-1979-5. Epub 2005 Jun 10.
White-coat hypertension (WCH) and masked hypertension have been associated with increased cardiovascular risk in adults. In the current study, we investigated: (a) the prevalence of WCH and masked hypertension in pediatric patients and (b) the association of these conditions with target organ damage. A total of 85 children underwent office blood pressure measurements, 24-h ambulatory blood pressure monitoring, echocardiography and ultrasonography of the carotid arteries. Subjects with both office and ambulatory normotension or hypertension were characterized as confirmed normotensives or hypertensives, respectively; WCH was defined as office hypertension with ambulatory normotension and masked hypertension as office normotension and ambulatory hypertension. WCH was found in 12.9% and masked hypertension in 9.4% of the subjects. WCH was significantly more prevalent in obese subjects, while masked hypertension was only present in non-obese ones. Confirmed and masked hypertensives had significantly higher left ventricular mass index than confirmed normotensives (34.0+/-5.8 g/m(2.7), 31.9+/-2.9 g/m(2.7) and 25.3+/-5.6 g/m(2.7), respectively, P<0.05). White-coat hypertensives tended to have higher left ventricular mass index than confirmed normotensives, but the difference was not statistically significant (27.8+/-5.1 g/m(2.7) versus 25.3+/-5.6 g/m(2.7)). No significant differences were found in the intima-media thickness of the carotid arteries between confirmed normotensives, white-coat hypertensives, masked hypertensives and confirmed hypertensives. WCH and masked hypertension are common conditions in children. Confirmed and masked hypertension in pediatric patients are accompanied by increased left ventricular mass index.
白大衣高血压（WCH）和隐匿性高血压与成人心血管风险增加有关。在本研究中，我们调查了：（a）儿科患者中WCH和隐匿性高血压的患病率，以及（b）这些情况与靶器官损害的关联。共有85名儿童接受了诊室血压测量、24小时动态血压监测、超声心动图和颈动脉超声检查。诊室和动态血压均为正常或高血压的受试者分别被归类为确诊正常血压者或高血压患者；WCH定义为诊室高血压伴动态血压正常，隐匿性高血压定义为诊室血压正常伴动态高血压。在12.9%的受试者中发现了WCH，9.4%的受试者中发现了隐匿性高血压。WCH在肥胖受试者中更为普遍，而隐匿性高血压仅见于非肥胖受试者。确诊高血压和隐匿性高血压患者的左心室质量指数显著高于确诊正常血压者（分别为34.0±5.8 g/m².⁷、31.9±2.9 g/m².⁷和25.3±5.6 g/m².⁷，P<0.05）。白大衣高血压患者的左心室质量指数往往高于确诊正常血压者，但差异无统计学意义（27.8±5.1 g/m².⁷对25.3±5.6 g/m².⁷）。确诊正常血压者、白大衣高血压患者、隐匿性高血压患者和确诊高血压患者之间的颈动脉内膜中层厚度无显著差异。WCH和隐匿性高血压在儿童中很常见。儿科患者中的确诊高血压和隐匿性高血压伴有左心室质量指数增加。
