Koncar Domagoj, Kovacevic Ana, Miler Marijana, La Grasta Sabolic Lavinia, Dika Zivka, Softic Dora, Valent Moric Bernardica
Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, HRV.
Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, HRV.
Cureus. 2024 Nov 27;16(11):e74550. doi: 10.7759/cureus.74550. eCollection 2024 Nov.
Background The rising incidence of hypertension (HTN) in pediatric patients imposes the need for its timely recognition by finding the optimal screening population. The goal of our study was to explore the ambulatory blood pressure (BP) parameters in selected groups of obese children and adolescents with different obesity levels and quantify the impact of parental hypertension (PH) on their blood pressure (BP) values. Methods This retrospective study included 176 obese Caucasian patients, 94 (53.4%) males, aged 6-18 years, who were divided based on their office blood pressure (OBP), body mass index (BMI) Z-score, and history of PH. Results Patients with PH had a significantly higher prevalence of masked hypertension (MH) and higher BMI (p=0.007 and p<0.001, respectively) compared to those with normotensive parents. There was no difference in whether HTN was of maternal or paternal origin, although the subjects with both hypertensive parents had higher diastolic blood pressure (DBP) parameters: office DBP (p=0.013), 24-hour DBP (p=0.017), and nighttime DBP (p=0.002). The multivariate regression analysis identified office systolic blood pressure (SBP) as a significant overall predictor of HTN (p<0.001), including the group with normotensive parents. In contrast, resting heart rate (HR) was an important predictor of HTN in subjects with PH (p=0.002). Additionally, a non-dipping BP pattern was predominantly observed in obese subjects, regardless of the degree of obesity (p=0.587). Conclusion Our results emphasize the importance of performing ambulatory blood pressure monitoring (ABPM) in obese children and adolescents, especially those with a history of PH. This group represents the target screening population for MH, which increases cardiovascular risk in this population when combined with obesity.
儿科患者高血压（HTN）发病率不断上升，因此需要通过确定最佳筛查人群来及时识别该病。我们研究的目的是探讨不同肥胖程度的肥胖儿童和青少年群体的动态血压（BP）参数，并量化父母高血压（PH）对其血压（BP）值的影响。方法：这项回顾性研究纳入了176名肥胖的白种人患者，其中94名（53.4%）为男性，年龄在6至18岁之间，根据其诊室血压（OBP）、体重指数（BMI）Z评分和PH病史进行分组。结果：与父母血压正常的患者相比，患有PH的患者隐匿性高血压（MH）患病率显著更高，BMI也更高（分别为p = 0.007和p < 0.001）。HTN源于母亲或父亲并无差异，不过父母双方均患有高血压的受试者舒张血压（DBP）参数更高：诊室DBP（p = 0.013）、24小时DBP（p = 0.017）和夜间DBP（p = 0.002）。多变量回归分析确定诊室收缩压（SBP）是HTN的一个重要总体预测指标（p < 0.001），包括父母血压正常的组。相比之下，静息心率（HR）是患有PH的受试者中HTN的一个重要预测指标（p = 0.002）。此外，无论肥胖程度如何，肥胖受试者中主要观察到非勺型血压模式（p = 0.587）。结论：我们的结果强调了对肥胖儿童和青少年，尤其是有PH病史的儿童和青少年进行动态血压监测（ABPM）的重要性。该群体是MH的目标筛查人群，与肥胖相结合时会增加该人群的心血管风险。
