Parent's blood pressure, waist and hip circumference are the keys to identifying masked hypertension in their kids, says a new study.
According to data unveiled at the American Society of Hypertension Inc.'s 25th Annual Scientific Meeting and Exposition (ASH 2010), children and adolescents who have parents with hypertension and larger waist (WC) and hip circumference (HC) should be evaluated for hypertension even if they exhibit normal blood pressure (BP) levels in the doctor's office.
Investigators found that these patients exhibited masked hypertension, which occurs when BP levels are normal when measured inside the doctor's office but increase when measured outside the doctor's office, when evaluated with ambulatory blood pressure monitoring (ABPM).
Masked hypertension is not rare in children and adolescents and implies an increased risk of cardiovascular disease.
"The children found to be hypertensive with ABPM were not even in a pre-hypertensive state in the doctor's office. Their blood pressure was normal," lead author of the study, Claudia Maria Salgado, adjunct professor, Department of Pediatrics and Hypertension League, Federal University of Goias, Brazil, said.
"The fact that the blood pressure rates for these patients escalated so significantly is alarming and warrants attention, if additional data confirm these findings," she said.
A total of 110 children and adolescents (aged 5-15) were included in this prospective study. Of the 110 enrolled, 99 completed the BP evaluation.
Participants were evaluated for family BP history, weight, height, body mass index and WC/HC. Data from 82 subjects who had an office BP lower than the 95th percentile were analysed.
Of these, 70 had normal BP and 12 were pre-hypertensive. Through ABPM, 10 were diagnosed with masked hypertension.
None of those considered pre-hypertensive presented with hypertension in the ambulatory setting. Children of hypertensive parents had more than a four-fold increased risk.
Children of hypertensive parents with abdominal obesity had a nine-fold increased risk of having masked hypertension. Age, sex, ethnicity and excess weight (simple obesity and overweight) had o influence on risk.