ESPN 54th Annual Meeting

ESPN 2022


 
Unattended automated office blood pressure measurement in children
TOMAS SEEMAN 4 KRYSTOF STANEK 1 JAKUB SLIZEK 1 JAN FILIPOVSKY 2 Janusz Feber 3

1- CHARLES UNIVERSITY PRAGUE, 2ND SCHOOL OF MEDICINE, CZECH REPUBLIC
2- DEPARTMENT OF INTERNAL MEDICINE II, CHARLES UNIVERSITY, MEDICAL FACULTY IN PILSEN, CZECH REPUBLIC
3- DIVISION OF NEPHROLOGY, DEPARTMENT OF PEDIATRICS, CHILDREN’S HOSPITAL OF EASTERN ONTARIO, UNIVERSITY OF OTTAWA, OTTAWA, CANADA
4- DPT. OF PEDIATRICS, LUDWIG-MAXIMILLIAN UNIVERSITY MUNICH, GERMANY
 
Introduction:

 We studied the performance of unattended automated office blood pressure (uAOBP) measurement in children, in relation to oscillometric office BP (OBP) and ambulatory blood pressure monitoring (ABPM).

Material and methods:

 111 stable treated and untreated outpatients investigated for hypertension underwent uAOBP measurements (seated unattended in a quiet room separate from the renal clinic room, six times after a 5 min rest with the BpTRU device). Ambulatory 24h blood pressure monitoring (ABPM) was performed on the same day in a subgroup of 42 children.

Results:

 UAOBP measurements were successful in 106 children (95%), 5 preschool children did not tolerate to be alone in the room. The mean±SD systolic/diastolic uAOBP, OBP and daytime ABP were 109.1 ± 14.0/70.8 ± 10.7 mmHg, 121.6 ± 16.5/77.6 ± 10.5 mmHg and 123.5 ± 11.3/73.7 ± 6.8 mmHg, respectively. Systolic/diastolic uAOBP was significantly lower than OBP by 13.6/7.6 mmHg (p<0.0001) and lower than daytime ABP by 14.4 ± 0.5/2.9 ± 0.3 mmHg (p<0.0001). The heart rate was not significantly different during uAOBP than during OBP measurements. On Bland Altman analysis the uAOBP underestimated OBP by a mean of 15.6 mmHg for systolic BP and by 8.6 mmHg for diastolic BP.  In all 9 children with white-coat systolic hypertension uAOBP was within the normal range (<95th pc for OBP), in six of nine children with white-coat diastolic hypertension uAOBP was within the normal range however, in three of them it was elevated despite normal ABP. 

Conclusions:

uAOBP measurement is feasible in school-aged children, its values are considerably lower than OBP as well as daytime ABP and it could help with detection of white-coat systolic hypertension. The clinical applicability of uAOBP in children should be confirmed in further studies.