ESPN 51th Annual Meeting

ESPN 2018


 
Impact assessment of ABPM parameters on the severity of overweight and obese hypertensive children
SERENA ASCIONE 1 LUIGI PETRUZZELLI ANNICHIARICO 1 ANNAMARIA PAGANO 1 LORENZA LEPORE 1 PASQUALE FABIO BARRA 1 CARMINE PECORARO 1 GABRIELE MALGIERI 1

1- PEDIATRIC NEPHROLOGY,SANTOBONO CHILDRENS HOSPITAL NAPOLI
 
Introduction:

 We describe the relationship between overweight and obesity and Hypertension on ABPM.

Material and methods:

 

We conducted a cross-sectional study using a database of patients aged 6-16 years,who had undergone 24h ABPM from December 2002 through December 2016.ABPM were performed using the validated device Spacelab 90217.

Were evaluated the 24h MAP,daytime MAP,nocturnal MAP, systolic and diastolic load,MAP Systolic and Diastolic.

Subjects were grouped by BMI Z-score into overweight (>1<2),obese (BMI Z-score >2<3)and severe obese (BMI Z-score >3).

A total  of 1016 patients were enrolled and recorded n.1210 ABPMs.

Obese pts were 202 (19.8%);126 M;76F;median age 10,2 y.

Overweight childrens were 97 (11.9%);52 M;45F;median age 8,4y.

Results:

Among overweight childrens (BMI Z-Score >1<2):12 (12.3%) had hypertension,22 (22.6%) pre-hypertension,15 (15.4%) MH;non dipping pattern was recorded in 26 (52%).48 were normotensive.Among obese childrens,122 had hypertension (60.3%):24 pts had Masked Hypertension (19.6%);72 (59.0%) had severe ambulatory hypertension with BMI z-score >3 (mean 3.8),and in this category all pts were both systolic and diastolic non dipping. 32 (64%) obese with BMI z-score >2<3 were non-dipping.Diastolic load was significantly higher (p >0,0001) in severe obese. 28 pts had ambulatory prehypertension (13.8%),11 pts had White Coat Hypertension (4.9%).41 pts had normotension (20.2%).

Conclusions:

The severity of ambulatory hypertension increased with increased BMI Z-score.The non-dipping status is associated,not only, with higher BMI Z-score,but was present in overweight and obese with BMI z-score >2<3 also.  

ABPM is an effective tool that should become routine in all obese patient,but also in overweight childrens,which may lead to better treatments and prevention methods.