Background: Emerging data suggest that ambulatory blood pressure (BP) monitoring for 24 h may be efficient in the diagnosis of hypertension in adults, children and adolescents. Additionally, in adults, it may predict the existence of some early BP abnormalities related to cardiovascular risk: (a) elevated BP load (>25%) and (b) non-dipping (BP decrease in night-time <10%).
Objective and hypotheses: To evaluate the presence of early BP abnormalities related to cardiovascular risk in obese children and adolescents. Contrast its prevalence with non-obese counterparts.
Method: Case-control study of 41 obese boys/36 obese girls (BMI≥30 kg/m2 for age and sex according to IOTF, 2000); mean age 11.5±2.1 S.D. It was selected a homogeneous control group (BMI from 18.5 to 25 kg/m2; IOTF, 2000) matched by sex, age and Tanner stage. Patients were monitored for 24 h BP (WatchBP 03). Parameters calculated: (a) BP load=percentage of readings above the ambulatory BP 95th percentile (AHA 2014). Calculated for the entire 24-h day, daytime and night-time periods. Abnormal if >25%. (b) Nocturnal BP decrease=(daytime mean of BP- night-time mean of BP)/daytime mean of BP×100. Abnormal if <10%.
Results: The percentage of individuals who had an abnormal BP load was generally higher in obese. In the 24-h-systolic BP register this difference was significant: 22.1% of obese vs 6.5% of non-obese (P<0.05). The mean value of SBP dipping was significantly more acute in non-obese compared to obese: 12.1% vs 9.8% (P<0.05). Non-dipping was present in up to 54.5% of the obese in the systolic register compared to 35.1% of controls (P<0.05).
Conclusion: The current study shows a high prevalence of early BP disturbances in obese children and adolescents. It would be interesting to extend the study; adding analytical markers related to cardiovascular risk and echocardiography evaluation.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology