ESPE Abstracts (2016) 86 P-P2-515

Early Blood Pressure Abnormalities Related to Cardiovascular Risk in Obese Children and Adolescents

Gonzalo Herráiz Gastesia, María Pilar Samper Villagrasab, Luis Moreno Aznarc, Rosaura Leis Trabazod, Concepción Aguilera Garcíae, Ángel Gil Hernándeze, Mercedes Gil-Camposf, Jesús María Garagorri Oteroa & María Gloria Bueno Lozanoa

aDepartment of Paediatrics, Endocrinology Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; bDepartment of Paediatrics, University of Zaragoza, Zaragoza, Spain; cHealth Sciences School, University of Zaragoza, Zaragoza, Spain; dResearch Group in Paediatrics Nutrition, Department of Paediatrics, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; eBiomedical Research Center, University of Granada, Granada, Spain; fResearch and Metabolism in Paediatrics Unit, Hospital Universitario Reina Sofía, Córdoba, Spain

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.