Usefulness of ambulatory blood pressure monitoring in diagnosis of arterial hypertension in children and adolescents

Background: Arterial hypertension in children and adolescents is an important medical problem with a prevalence rising over the last ten years from 1 to 4.5%. Aim: To assess the usefulness of ambulatory blood pressure monitoring (ABPM) in diagnosis of arterial hypertension in children and adolescents. Methods: Two hundred and twelve children with elevated blood pressure (BP) and 81 healthy controls participated in this study. In all children from the study and control groups standard BP measurement and ABPM were performed. Results: With the use of standard BP measurement, 168 (79.2%) children were diagnosed as hypertensive and the remaining 44 (20.8%) as prehypertensive. When the ABPM was used, arterial hypertension was diagnosed in 143 (67.4%) cases and white coat hypertension in the remaining 69 (32.6%) subjects. In 7 (8.7%) control children elevated BP in ABPM was detected, and masked hypertension were diagnosed. Conclusions: 1. Ambulatory blood pressure monitoring is a useful tool in diagnosis of arterial hypertension in children and adolescents. 2. Systolic hypertension is a major form of hypertension in childhood. 3. Ambulatory blood pressure monitoring is helpful to identify patients with white coat hypertension. 4. Further studies are necessary to establish uniform indications, standards and rules for interpretation of ABPM in children and adolescents.