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

Published online by Cambridge University Press:  25 January 2011

Manish D. Sinha ,
Caroline J. Booth  and
Christopher J.D. Reid
Manish D. Sinha*
Affiliation:
Department of Paediatric Nephrology, Evelina Children's Hospital, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
Caroline J. Booth
Affiliation:
Department of Paediatric Nephrology, Evelina Children's Hospital, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
Christopher J.D. Reid
Affiliation:
Department of Paediatric Nephrology, Evelina Children's Hospital, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
*
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
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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.

Keywords

Qualityrenalpaediatrics
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 3 , June 2011 , pp. 310 - 316
Copyright
Copyright © Cambridge University Press 2011

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References

1. Hornsby, JL, Mongan, PF, Taylor, AT, Treiber, FA. ‘White coat’ hypertension in children. J Fam Pract 1991; 33: 617–623.Google ScholarPubMed
2. Sorof, JM, Cardwell, G, Franco, K, Portman, RJ. Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 2002; 39: 903–908.CrossRefGoogle ScholarPubMed
3. Mule, G, Nardi, E, Andronico, G, et al. . Relationships between 24-h blood pressure load and target organ damage in patients with mild-to-moderate essential hypertension. Blood Press Monitor 2001; 6: 15–23.Google Scholar
4. White, WB, Dey, HM, Schulman, P. Assessment of the daily blood pressure load as a determinant of cardiac function in patients with mild to-moderate hypertension. Am Heart J 1989; 118: 782–795.CrossRefGoogle ScholarPubMed
5. Dolan, E, Stanton, A, Thijs, L, et al. . Superiority of ambulatory over clinic blood pressure measurement in predicting mortality the dublin outcome study. Hypertension 2005; 46: 156–161.CrossRefGoogle ScholarPubMed
6. Ohkubo, T, Hozawa, A, Nagai, K, et al. . Prediction of stroke by mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements in a general population: the Ohasama study. J Hypertens 2000; 18: 847–854.CrossRefGoogle Scholar
7. Clement, DL, De Buyzere, M, De Bacquer, DA, et al. . For the office versus ambulatory blood pressure (ova) study investigators. Prognostic value of ambulatory blood pressure recordings in patients with treated hypertension. N Engl J Med 2003; 348: 207–215.CrossRefGoogle Scholar
8. Soergel, M, Kirschstein, M, Busch, C, et al. . Oscillometric twenty four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 1997; 130: 178–184.CrossRefGoogle ScholarPubMed
9. Wuhl, E, Witte, K, Soergel, M, et al. . German working group on pediatric hypertension. Distribution of 24-h ambulatory blood pressure in children: normalised reference values and role of body dimensions. J Hypertens 2002; 20: 1995–2007.CrossRefGoogle Scholar
10. Graves, JW, Althaf, MM. Utility of ambulatory blood pressure monitoring in children and adolescents. Pediatr Nephrol 2006; 21: 1640–1652.CrossRefGoogle ScholarPubMed
11. Jacoby, AC, Fixler, DE, Torres, EJ. Limitations of an oscillometric ambulatory blood pressure monitor in physically active children. J Pediatr 1993; 122: 231–236.CrossRefGoogle ScholarPubMed
12. Portman, RJ, Yetman, RJ, Stewart West, M. Efficacy of 24-hour ambulatory blood pressure monitoring in children. J Pediatr 1991; 118: 842–849.CrossRefGoogle ScholarPubMed
13. Portman, RJ, Yetman, RJ. Clinical use of ambulatory blood pressure monitoring. Pediatr Nephrol 1994; 8: 367–376.CrossRefGoogle ScholarPubMed
14. Verdecchia, P, Angeli, F, Borgioni, C, Gattobigio, R, Reboldi, G. Ambulatory blood pressure and cardiovascular outcome in relation to perceived sleep deprivation. Hypertension 2007; 49: 777–783.CrossRefGoogle ScholarPubMed
15. Lurbe, E, Cremades, B, Rodriguez, C, Torro, MI, Alvarez, V, Redon, J. Factors related to quality of ambulatory blood pressure monitoring in a pediatric population. Am J Hypertens 1999; 12: 929–933.CrossRefGoogle Scholar
16. Schwartz, GJ, Haycock, GB, Edelmann, CM Jr, Spitzer, A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976; 58: 259–263.CrossRefGoogle ScholarPubMed
17. Lurbe, E, Alvarez, V, Liao, Y, et al. . The impact of obesity and body fat distribution on ambulatory blood pressure in children and adolescents. Am J Hypertens 1998; 11: 418–424.CrossRefGoogle ScholarPubMed
18. Fravel, MA, Ernst, ME, Weber, CA, Dawson, JD, Carter, BL, Bergus, GR. Influence of patient characteristics on success of ambulatory blood pressure monitoring. Pharmacotherapy 2008; 28: 1341–1347.CrossRefGoogle ScholarPubMed
19. Davis, ID, Baron, J, O'Riordan, MA, Rosen, CL. Sleep disturbances in pediatric dialysis patients. Pediatr Nephrol 2005; 20: 69–75.CrossRefGoogle ScholarPubMed
20. Applebee, GA, Guillot, AP, Schuman, CC, Teddy, S, Attarian, HP. Restless legs syndrome in pediatric patients with chronic kidney disease. Pediatr Nephrol 2009; 24: 545–548.CrossRefGoogle ScholarPubMed