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Ambulatory blood pressure and blood pressure variability in obese children with office normotension

Introduction Obese children have an approximately 3-fold higher risk of hypertension than normal weight children. Our aim was to analyze ambulatory blood pressure (ABP) and blood pressure (BP) variability in office normotensive obese children. Material and methods The APB results of 50 obese office normotensive children (mean age 14, 15 ± 2, 29 years) and 35 normal weight office normotensive children (mean age 14, 57 ± 2, 17 years) were compared. We analysed office BP, systolic and diastolic ABP, pulse pressure, nocturnal dipping, morning BP surge and BP variability. Results There were no differences in age, sex, height and office BP between obese and normal weight subjects. Obese children had significantly higher 24 hour, daytime and nighttime systolic ABP (p=0, 016, p=0, 02 and p=0, 01, respectively) and pulse pressure (all p<0, 01) compared to normal weight children. The prevalence of masked hypertension was 17 % in obese group while none of the normal weight children had masked hypertension. Obese children also had higher heart rate than normal weight children. No differences were observed for diastolic BP and dipping status between the two groups. Obese children had significantly higher values of morning BP surge (p<0, 01). All BP variability parameters over a 24-hour period (systolic BP, diastolic BP and pulse pressure) were also significantly higher in obese children (p<0, 01). Conclusions Obesity has significant impact on ABP even in office normotensive children. Higher ABP, more pronounced BP variability and higher morning BP surge found in obese children are known risk factors of adverse cardiovascular outcomes in adults. Therefore, early recognition of higher ABP values in office normotensive obese children requires follow-up and lifestyle changes in order to prevent development of sustained hypertension.

ambulatory blood pressure ; children ; obesity

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