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Arterial stiffness in children and adolescents with masked and sustained hypertension

Journal of Human Hypertension volume 35, pages 85–93 (2021)Cite this article

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Abstract

This study recruited 85 healthy children and adolescents, aged 6–18 years, from a school-based blood pressure (BP) screening study and performed office BP measurements, 24-h ambulatory blood pressure monitoring (24-h ABPM) and 24-h pulse wave analysis. Prevalence of BP phenotypes was assessed, factors that may predict hypertension (HTN) in ABPM were examined and the effect of BP phenotypes, as well as school, office, and ambulatory BP parameters on pulse wave velocity (PWV), was investigated. Forty-five (54.9%) of the children were normotensives, 8 (9.7%) were white coat hypertensives (WCH), 19 (23.2%) had masked hypertension (MH), and 10 (12.2%) had sustained HTN. Estimated adjusted marginal means for 24-h PWV were 4.79 m/s (95% CI 4.65–4.94) for sustained hypertensives, 4.72 m/s (95% CI 4.62–4.82) for MH, 4.38 m/s (95% CI 4.23–4.54) for WCH, and 4.33 m/s (95% CI 4.26–4.40) for normotensives (sustained hypertensives versus normotensives and WCH, p < 0.001, MH versus normotensives and WCH, p < 0.005). Neither body mass index (BMI) z-score nor school systolic BP (SBP) z-score could predict HTN by ABPM. Office SBP z-score was associated with 1.74 times increased odds ratio to have HTN in ABPM. Sustained HTN and MH were independent predictors of 24-h PWV after adjustment for age, sex, and BMI z-score. In conclusion, arterial stiffness in children and adolescents was assessed by 24-h PWV associates with mean ambulatory BP. Both school and office BP measurements could not predict HTN in ABPM or increasing PWV. HTN in ABPM was independently associated with the risk of higher PWV compared with normotensive and WCH phenotype.

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The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. These authors contributed equally: Konstantinos Kollios, Thomaitsa Nika

Authors and Affiliations

  1. 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece

    Konstantinos Kollios & Thomaitsa Nika

  2. 3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Hypertension-24h ABPM Center, Papageorgiou General Hospital, Thessaloniki, Greece

    Vasilios Kotsis & Christina Antza

  3. 1st Department of Pediatrics, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece

    Katerina Chrysaidou & Stella Stabouli

Authors
  1. Konstantinos Kollios
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  2. Thomaitsa Nika
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  3. Vasilios Kotsis
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  4. Katerina Chrysaidou
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  5. Christina Antza
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  6. Stella Stabouli
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Contributions

KK and TN: performed data collection, drafted the initial manuscript, revised and approved the final version; KC and CA: analyzed the data and approved the final version; VK and SS: designed the study and edited, revised and approved the final version.

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Correspondence to Thomaitsa Nika.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures in the study were in accordance with the ethical standards of the Greek Ministry of National Education, the National Educational Institute, and the Ethics Committee of Aristotle University of Thessaloniki, which approved the study protocol (65104/Γ7/15-05-2013).

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Informed consent was obtained from all individual participants included in the study and their parents or legal guardians.

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Kollios, K., Nika, T., Kotsis, V. et al. Arterial stiffness in children and adolescents with masked and sustained hypertension. J Hum Hypertens 35, 85–93 (2021). https://doi.org/10.1038/s41371-020-0318-4

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