Can ambulatory blood pressure monitoring over 24 hours in children and adolescents with insulin-dependent diabetes mellitus provide clues for early detection of risk for hypertension?

Aim: Early recognition of hypertension was attempted during clinical management of young patients with insulin-dependent diabetes mellitus using ambulatory 24-hour-blood pressure monitoring. Methods: In this study 24-hour-blood-pressure measurements were recorded in 48 children with diabetes (24 girls and 24 boys, range from 9 to 18 years). A reference group of 48 sex-, age-, height- and weight matched healthy children was studied in parallel. Results: None of the children with diabetes was hypertensive by standard criteria, However, both systolic and diastolic blood pressure values exceeded the values of the reference group by 4 and 6 mm Hg respectively (method of moving interval averages), Using more conventional statistical methods (mean of day or night time blood pressure values) similar results were obtained (p < 0.001, unpaired t test). Children who had bad metabolic control (HbA1c > 7%, median) had higher diastolic blood pressure profiles. Conclusion: We conclude that ambulatory blood pressure monitoring must be performed in longitudinal, multicenter studies. Whether or not ambulatory blood pressure monitoring can provide clues for the early detection of patients at risk for developing hypertension is still unclear.