Department of Pediatrics, Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Am J Hypertens. 2011 Aug;24(8):893-7. doi: 10.1038/ajh.2011.72. Epub 2011 Apr 28.
To evaluate the effect of the environment and the observer on the measurement of blood pressure (BP) as well as to compare home BP (HBP) and ambulatory BP (ABP) measurements in the diagnosis of white coat hypertension (WCH) and masked hypertension (MH) in children and adolescents with hypertension (HT).
BP of 40 patients with HT (75% of which had secondary HT and were on antihypertensive medication), mean age 12.1 years was evaluated through casual measurements at the clinic and at the HT unit, HBP for 14 days with the OMRON HEM 705 CP monitor (Omron, Tokyo, Japan) and ABP performed with SPACELABS 90207 (Spacelabs, Redmond, WA), for 24 h.
HT was diagnosed at the doctor's office by ABP and HBP in 30/40, 27/40, and 31/40 patients, respectively. Based on office BP and ABP, 60% of patients were normotensive, 17.5% HT, 7.5% had WCH, and 15% had MH, whereas based on office BP and HBP 65, 12.5, 10, and 12.5% of patients were classified according to these diagnoses, respectively. There was considerable diagnostic agreement of HT by ABP and HBP (McNemar test, P < 0.01) (κ = 0.56).
In hypertensive children and adolescents, HBP and ABP present comparable results. HBP appears to be a useful diagnostic test for the detection of MH and WCH in pediatric patients.
评估环境和观察者对血压（BP）测量的影响，并比较儿童和青少年高血压（HT）患者中家庭血压（HBP）和动态血压（ABP）测量在白大衣高血压（WCH）和隐蔽性高血压（MH）诊断中的作用。
评估 40 名 HT 患者（其中 75%为继发性 HT 且正在服用降压药物）的 BP，平均年龄 12.1 岁，在诊所和 HT 病房进行偶然测量，使用 OMRON HEM 705 CP 监测仪（欧姆龙，东京，日本）进行 14 天的 HBP 测量，使用 SPACELABS 90207（Spacelabs，雷蒙德，WA）进行 24 小时 ABP 测量。
ABP 和 HBP 在 30/40、27/40 和 31/40 名患者中分别诊断出 HT。根据诊室 BP 和 ABP，60%的患者血压正常，17.5%的患者 HT，7.5%的患者 WCH，15%的患者 MH，而根据诊室 BP 和 HBP，65%、12.5%、10%和 12.5%的患者分别按照这些诊断进行分类。ABP 和 HBP 诊断 HT 的一致性较好（McNemar 检验，P < 0.01）（κ = 0.56）。
在高血压儿童和青少年中，HBP 和 ABP 具有相似的结果。HBP 似乎是检测儿科患者 MH 和 WCH 的有用诊断试验。
