Mitsnefes Mark M, Pierce Chris, Flynn Joseph, Samuels Joshua, Dionne Janis, Furth Susan, Warady Bradley
Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue ML 7022, Cincinnati, OH, 45229, USA.
Johns Hopkins University School of Public Health, Baltimore, MD, USA.
Pediatr Nephrol. 2016 Jan;31(1):163-6. doi: 10.1007/s00467-015-3212-5. Epub 2015 Sep 28.
Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP).
METHODS/RESULTS: We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60 %), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7 %, and of abnormal BP load was 6-16 %.
These data suggest that masked hypertension is unlikely if the casual BP is found to be in the low normal range.
对慢性肾脏病患儿的研究表明，通过动态血压监测（ABPM）检测到的隐匿性高血压患病率很高。然而，隐匿性高血压的发生率是否与正常偶测血压（BP）水平相关尚不清楚。
方法/结果：我们假设正常偶测血压水平较低与隐匿性高血压患病率较低相关。对慢性肾脏病（CKiD）队列多次访视的数据进行横断面分析。大多数偶测血压正常的儿童清醒和睡眠时的动态血压也正常（60%），即使在偶测血压的最高百分位数时也是如此。在清醒和睡眠期间，偶测血压≤第25百分位数的儿童隐匿性高血压的发生率低于偶测血压在第 26-50百分位数和第51-90百分位数的儿童。在正常偶测血压水平最低（≤第25百分位数）的儿童中，平均清醒或睡眠动态血压异常的发生率为2%-7%，血压负荷异常的发生率为6%-16%。
这些数据表明，如果偶测血压处于正常低范围，则隐匿性高血压不太可能发生。
