ESPN 51th Annual Meeting

ESPN 2018


 
ABPM in obese and non overweight hypertensive children:what’s the difference
LORENZA LEPORE 1 ANNAMARIA PAGANO 1 SERENA ASCIONE 1 PASQUALE FABIO BARRA 1 CARMINE PECORARO 1 GABRIELE MALGIERI 1

1- PEDIATRIC NEPHROLOGY,SANTOBONO CHILDRENS HOSPITAL NAPOLI
 
Introduction:

 The goal of our study was to analyze the difference in ABPM pattern in overweight and non overweight hypertensive children.

Material and methods:

The ABPM were performed using Spacelab 90207 and recorded over 24h.Readings were taken every 15 minutes while awake,and every 20 minutes while asleep.In both groups were evaluated the 24h MAP,daytime MAP,nocturnal MAP, systolic and diastolic load,mean 24h SBP and DBP.

A total of 108 pts were enrolled.Pts were divided in two groups.In the first group 54 pts non overweight with primary hypertension:33 male and 21 female with mean age of 10.4 y.In the second group the obese hypertensive children,with mean age of 10.5 y, were divided into two subgroups according to BMI Z-scores:subgroup 1 BMI Z-score >2<3  n 40 pts (17 f;21m);subgroup 2 BMI Z-score >3  n (4f;10m).

Results:

 Systolic load was significantly higher in obese group  (p 0,0409).In obese group n.12 were dipper (22,2%).Obese with BMI z-score >3 was all non dipper (n14 ;100%).In the lean group n 26 was dipper (48.1%),and 28 (51.8%) non dipper.24 h MAP,Systolic and Diastolic load were significantly higher (p 0,0001) in the obese with BMI z score >3 compared to the lean group.

Conclusions:

 The statistically significant pathological pattern among obese is the increase in mean PAS and systolic load, as well as the absence of night dipping in severe obese. The increase in systolic load is already evident in obese mild. This gives a significant predictive value of cardiovascular damage to ABPM which increases with the severity of obesity worse.