White Coat Hypertension Persistence in Children and Adolescents: The Pediatric Nephrology Research Consortium Study.
White Coat Hypertension Persistence in Children and Adolescents: The Pediatric Nephrology Research Consortium Study.
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DOI：
10.1016/j.jpeds.2022.03.036
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发表时间：
2022-07
影响因子：
5.1
通讯作者：
Flynn, Joseph T.
中科院分区：
文献类型：
--
作者：
Miyashita, Yosuke;Hanevold, Coral;Faino, Anna;Scher, Julia;Lande, Marc;Yamaguchi, Ikuyo;Hernandez, Joel;Acosta, Alisa;Weaver, Donald J., Jr.;Thomas, Jason;Kallash, Mahmoud;Ferguson, Michael;Patel, Ketan N.;South, Andrew M.;Kelton, Megan;Flynn, Joseph T.
确定初始动态血压监测（ABPM）时患有白色被毛青年高血压的患者在重复ABPM时是否继续表现出相同的模式。对因高血压（BP）转诊并通过ABPM诊断为白色被毛高血压的患者进行的回顾性纵向队列研究，这些患者在儿科肾病研究联盟的11家中心进行了0.5-4.6年的随访ABPM。我们使用美国心脏协会指南对ABPM表型进行分类。基线时，我们将门诊高血压患者分类为“稳定型白色被毛高血压”，将血压正常的患者分类为“间歇性白色被毛高血压”。我们使用多变量广义线性混合效应模型来估计基线特征与异常ABPM表型进展的相关性。89例患者符合入选标准（中位年龄13.9岁; 78%为男性）。ABPM测量之间的中位间隔时间为14个月。在随访ABPM时，61%进展为异常ABPM表型（23%动态高血压，38%动态高血压前期）。12-17岁的个体和那些稳定的白色被毛高血压患者进展为高血压前期或动态高血压的比例更大。在多变量模型中，基线清醒收缩压指数≥0.9与进展为动态高血压的几率较高显著相关（OR 3.07，95%CI 1.02-9.23）。大多数患有白色被毛高血压的患者进展为异常ABPM表型。本研究支持2017年美国儿科学会临床实践指南关于白色被毛高血压患者ABPM随访的建议。
To determine whether youth with white coat hypertension on initial ambulatory blood pressure monitoring (ABPM) continue to demonstrate the same pattern on repeat ABPM. Retrospective longitudinal cohort study of patients referred for high blood pressure (BP) and diagnosed with white coat hypertension by ABPM who had follow-up ABPM 0.5-4.6 years later at 11 centers in the Pediatric Nephrology Research Consortium. We classified ABPM phenotype using the American Heart Association guidelines. At baseline, we classified those with hypertensive BP in the clinic as “stable white coat hypertension,” and those with normal BP as “intermittent white coat hypertension.” We used multivariable generalized linear mixed effect models to estimate the association of baseline characteristics with abnormal ABPM phenotype progression. Eighty-nine patients met the inclusion criteria (median age, 13.9 years; 78% male). Median interval time between ABPM measurements was 14 months. On follow-up ABPM, 61% progressed to an abnormal ABPM phenotype (23% ambulatory hypertension, 38% ambulatory prehypertension). Individuals age 12-17 years and those with stable white coat hypertension had greater proportions progressing to either prehypertension or ambulatory hypertension. In the multivariable models, baseline wake systolic BP index ≥0.9 was significantly associated with higher odds of progressing to ambulatory hypertension (OR 3.07, 95% CI 1.02-9.23). The majority of the patients with white coat hypertension progressed to an abnormal ABPM phenotype. This study supports the 2017 American Academy of Pediatrics Clinical Practice Guideline’s recommendation for follow-up of ABPM in patients with white coat hypertension.
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影响因子：
1.5
作者：
Jurko, Alexander;Jurko, Tomas;Tonhajzerova, Ingrid
通讯作者：
Tonhajzerova, Ingrid
影响因子：
8.3
作者：
Mancia, Giuseppe;Bombelli, Michele;Grassi, Guido
通讯作者：
Grassi, Guido
影响因子：
8.3
作者：
Mancia, Giuseppe;Facchetti, Rita;Bombelli, Michele
通讯作者：
Bombelli, Michele
影响因子：
8.3
作者：
Mancia, Giuseppe;Bombelli, Michele;Sega, Roberto
通讯作者：
Sega, Roberto
影响因子：
5.8
作者：
Shankar, RR;Eckert, GJ;Pratt, JH
通讯作者：
Pratt, JH