Cardiology in the Young

Original Articles

Factors affecting success of blood pressure measurements during ambulatory blood pressure monitoring in children with renal disease

Manish D. Sinhaa1 c1, Caroline J. Bootha1 and Christopher J.D. Reida1

a1 Department of Paediatric Nephrology, Evelina Children's Hospital, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom

Abstract

Aim To analyse blood pressure characteristics during 24-hour ambulatory blood pressure monitoring in children and to assess factors that influence its success over 24 hours and during patient-recorded awake (DAY) and sleep (NIGHT) periods.

Methods A total of 169 consecutive ambulatory blood pressure monitoring studies were conducted in 154 patients over 30 months. For each ambulatory study, we measured the percentage of successful measurements both at the first attempt (S-initial%) and following any automated repeat attempt if initial attempts had failed (S-final%). These were measured over 24-hour, DAY, and NIGHT periods.

Results We found that blood pressure measurements at NIGHT were more successful than measurements attempted during the DAY (p<0.05). There was no influence of age, gender, height, weight, body mass index and estimated glomerular filtration rate with the proportion of successful measurements during the 24-hour, DAY, and NIGHT periods. On stepwise multiple regression analysis, the indexed mean systolic blood pressure over 24 hours was the only factor having a significant influence on the proportion of successful measurements over the 24-hour and DAY periods, although it only accounted for three-tenths of the variance; it had no influence on the overall success of measurements at NIGHT.

Conclusion Ambulatory blood pressure monitoring in children provides reliable data both during the patient's awake and sleep periods with higher success of measurements at NIGHT as opposed to DAY periods.

(Received May 02 2010)

(Accepted December 08 2010)

(Online publication January 25 2011)

Correspondence:

c1 Correspondence to: Dr Manish D. Sinha, Department of Paediatric Nephrology, Room 64, Sky Level, Evelina Children's Hospital, Guys and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom. Tel: +44 20 7188 4587; Fax: +44 20 7188 4591; E-mail: manish.sinha@gstt.nhs.uk