Persistence and determinants of blood pressure phenotypes according to office and ambulatory blood pressure measurements in youth.
Ambulatory BP
BP phenotype
Masked hypertension
Persistence
White coat hypertension
Journal
Hypertension research : official journal of the Japanese Society of Hypertension
ISSN: 1348-4214
Titre abrégé: Hypertens Res
Pays: England
ID NLM: 9307690
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
03
10
2022
accepted:
12
12
2022
revised:
07
12
2022
medline:
9
5
2023
pubmed:
13
1
2023
entrez:
12
1
2023
Statut:
ppublish
Résumé
Ambulatory BP monitoring is increasingly used in children and adolescents, and the persistence of discrepant phenotypes, such as white coat or masked hypertension, is a relevant issue. The objective of this study was to assess the persistence of BP phenotypes over time and the factors related to their persistence. The study included 582 children and adolescents (9.4 ± 2.8 years of age) of both sexes (51% females) referred for routine health maintenance. Anthropometric parameters and office and 24-h ABPM measurements were obtained twice (interval 19.5 ± 6.9 months). BP classification and phenotypes were qualified using the 2016 ESH Guidelines. The correlation coefficient and kappa statistics were used to assess the persistence of phenotypes, and the related factors were evaluated using logistic regression. Based on both systolic and diastolic BP measurements, 91.6%, 16%, 17.2% and 13.7% of the subjects with true normotension, sustained HTN, white coat HTN and masked HTN, respectively, remained in the same category (overall agreement 74.2%, kappa 0.20). The multivariate model predicted the lack of persistence and correctly classified 90.3% of the subjects, with the pathological baseline BP phenotype (mainly masked HTN) being the independent variable that contributed most to the model. Excluding the phenotypes, the rest of the model explained 14% of the lack of persistence, and a high office SBP and high waist circumference were related to the lack of persistence. Furthermore, subjects who experienced an increase in their BMI z score and change in their BMI category were at risk of a lack of persistence. In conclusion, children, especially those with BP phenotypes different from true normotension, should be re-evaluated because a large percentage are likely to become normotensive.
Identifiants
pubmed: 36635525
doi: 10.1038/s41440-022-01159-w
pii: 10.1038/s41440-022-01159-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1257-1266Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.
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