Department of Pediatrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Zagreb, Croatia.
J Pediatr Endocrinol Metab. 2020 Aug 18;33(10):1313-1320. doi: 10.1515/jpem-2020-0269.
Objectives The objectives of this study were to analyze ambulatory blood pressure (ABP) data in office normotensive obese children, to determine the prevalence and characteristics of masked hypertension (MH) and to investigate the impact of parental hypertension (PH) on ABP. Methods Seventy-nine obese and 35 normal weight children were enrolled. Each weight group was further divided in accordance with the presence of PH. ABP was recorded in an outpatient setting. Results Obese children had higher systolic ABP (p<0.05) and heart rate (p<0.001) compared with normal weight children. In obese children with PH, only nighttime systolic ABP (p=0.01) was higher compared with obese without PH, whereas normal weight children with PH had higher 24 h and daytime systolic and diastolic BP (all p<0.05) and nighttime DBP (p<0.001) compared with those without PH. PH but not obesity was associated with nondipping phenomenon. Prevalence of MH in the whole group was 23.6% being significantly higher in obese than in nonobese subjects (31.6 vs. 5.7%; p=0.0026) as well as in obese subjects with PH compared with obese subjects without PH (48.7 vs. 15%; χ2=10.37; p=0.001). MH was diagnosed more frequently in obese with high-normal office BP compared with obese with normal office BP, although it did not reach statistical significance (50 vs. 26.2%; χ2=3.631; p=0.056). In the normal weight group, neither PH nor office BP category had an impact on the prevalence of MH. Conclusions Office normotensive obese children had higher ABP values. MH was associated with obesity, PH and high-normal BP.
本研究旨在分析门诊血压正常肥胖儿童的动态血压（ABP）数据，确定掩蔽性高血压（MH）的患病率和特征，并探讨父母高血压（PH）对 ABP 的影响。
共纳入 79 例肥胖儿童和 35 例正常体重儿童。根据 PH 的存在，每个体重组进一步分为两组。在门诊环境中记录 ABP。
与正常体重儿童相比，肥胖儿童的收缩压 ABP（p<0.05）和心率（p<0.001）更高。在有 PH 的肥胖儿童中，只有夜间收缩压 ABP（p=0.01）高于无 PH 的肥胖儿童，而有 PH 的正常体重儿童的 24 小时和日间收缩压和舒张压（均 p<0.05）以及夜间舒张压（p<0.001）均高于无 PH 的正常体重儿童。PH 而非肥胖与非杓型有关。整个组中 MH 的患病率为 23.6%，肥胖儿童明显高于非肥胖儿童（31.6%比 5.7%；p=0.0026），肥胖儿童中 PH 组明显高于无 PH 组（48.7%比 15%；χ2=10.37；p=0.001）。与肥胖儿童正常办公室 BP 相比，办公室 BP 高正常的肥胖儿童 MH 诊断频率更高，尽管差异无统计学意义（50 比 26.2%；χ2=3.631；p=0.056）。在正常体重组中，PH 或办公室 BP 类别均未影响 MH 的患病率。
门诊血压正常的肥胖儿童的 ABP 值更高。MH 与肥胖、PH 和高正常 BP 有关。
