ABPM vs. office blood pressure to define blood pressure control in treated hypertensive paediatric renal transplant recipients

被引:35
作者
Ferraris, Jorge R.
Ghezzi, Lidia
Waisman, Gabriel
Krmar, Rafael T. [1 ]
机构
[1] Karolinska Univ Hosp, Div Paediat, Dept Clin Sci Intervent & Technol, Karolinska Inst, S-14186 Huddinge, Sweden
[2] Hosp Italiano Buenos Aires, Serv Nefrol Pediat, Hop Italiano, Buenos Aires, DF, Argentina
[3] Hosp Italiano Buenos Aires, Unidad Hipertens Arterial, Serv Clin Med, Buenos Aires, DF, Argentina
关键词
renal transplantation; office blood pressure; ambulatory blood pressure; blood pressure control;
D O I
10.1111/j.1399-3046.2006.00595.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplants. Controlled office BP was defined as the mean of three replicate systolic and diastolic BP recordings less than or equal to the 95th age-, sex- and height-matched percentile on the three-outpatient visits closest to ABPM. Controlled ABPM was defined as systolic and diastolic daytime BP ! 95th distribution adjusted height- and sex-related percentile of the adapted ABPM reference. Eight recipients (30%) with controlled office BP were in fact categorized as having non-controlled BP by ABPM criteria. Overall, when office BP and ABPM were compared using the Bland and Altman method, the 95% limits of agreement between office and daytime values ranged from -12.6 to 34.1 mmHg for systolic and -23.9 to 31.7 mmHg for diastolic BP, and the mean difference was 10.7 and 3.9 mmHg respectively. Office readings miss a substantial number of recipients who are hypertensive by ABPM criteria. Undertreatment Of hypertension could be avoided if ABPM is applied as an adjunct to office readings.
引用
收藏
页码:24 / 30
页数:7
相关论文
共 35 条
[1]  
BALUARTE HJ, 1994, PEDIATR NEPHROL, V8, P570
[2]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[3]   Pathomechanisms and the diagnosis of arterial hypertension in pediatric renal allograft recipients [J].
Büscher, R ;
Vester, U ;
Wingen, AM ;
Hoyer, P .
PEDIATRIC NEPHROLOGY, 2004, 19 (11) :1202-1211
[4]   Hypertension in young patients after renal transplantation - Ambulatory blood pressure monitoring versus casual blood pressure [J].
Calzolari, A ;
Giordano, U ;
Matteucci, MC ;
Pastore, E ;
Turchetta, A ;
Rizzoni, G ;
Alpert, B .
AMERICAN JOURNAL OF HYPERTENSION, 1998, 11 (04) :497-501
[5]   Establishing a standard definition for child overweight and obesity worldwide: international survey [J].
Cole, TJ ;
Bellizzi, MC ;
Flegal, KM ;
Dietz, WH .
BMJ-BRITISH MEDICAL JOURNAL, 2000, 320 (7244) :1240-1243
[6]   Elevated blood pressure predicts the risk of acute rejection in renal allograft recipients [J].
Cosio, FG ;
Pelletier, RP ;
Pesavento, TE ;
Henry, ML ;
Ferguson, RM ;
Mitchell, L ;
Lemeshow, S .
KIDNEY INTERNATIONAL, 2001, 59 (03) :1158-1164
[7]   BLOOD-PRESSURE IN CHILDHOOD - POOLED FINDINGS OF 6 EUROPEAN STUDIES [J].
DEMAN, SA ;
ANDRE, JL ;
BACHMANN, H ;
GROBBEE, DE ;
IBSEN, KK ;
LAASER, U ;
LIPPERT, P ;
HOFMAN, A .
JOURNAL OF HYPERTENSION, 1991, 9 (02) :109-114
[8]  
Domino FJ, 2005, AM FAM PHYSICIAN, V71, P2089
[9]   Mortality and causes of death of end-stage renal disease in children: A Dutch cohort study [J].
Groothoff, JW ;
Gruppen, MP ;
Offringa, M ;
Hutten, J ;
Lilien, MR ;
van de Kar, NJ ;
Wolff, ED ;
Davin, JC ;
Heymans, HSA .
KIDNEY INTERNATIONAL, 2002, 61 (02) :621-629
[10]   RISK-FACTORS FOR ACCELERATED ATHEROSCLEROSIS IN RENAL-TRANSPLANT RECIPIENTS [J].
KASISKE, BL .
AMERICAN JOURNAL OF MEDICINE, 1988, 84 (06) :985-992