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Ambulatory Blood Pressure: Methodology and Norms in Children

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Pediatric Hypertension

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

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Abstract

Office BP readings taken as part of routine vital signs determination are subject to error especially if automated devices are used. Furthermore, office BP measures cannot rule out the “white-coast” effect (BP levels are normal outside of a medical setting though high in the office) or identify “masked” HTN (normal office but high out-of-office BP levels). To address these issues, ambulatory blood pressure monitoring (ABPM) has seen increasing use. Due to its superior accuracy in classifying BP levels, ABPM has also been shown to be cost-effective in the evaluation of childhood hypertension as compared to repeat office visits, and recent guidelines have given more consideration to routine use of ABPM. In this chapter, we will discuss the use and interpretation of ABPM.

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Abbreviations

ABPM:

Ambulatory blood pressure monitoring

BP:

Blood pressure

cIMT:

Carotid intima-media thickness

CKD:

Chronic kidney disease

CV:

Cardiovascular

GFR:

Glomerular filtration rate

HTN:

Hypertension

LVH:

Left ventricular hypertrophy

LVMI:

Left ventricular mass index

MAP:

Mean arterial pressure

MH:

Masked HTN

OSA:

Obstructive sleep apnea

PWV:

Pulse wave velocity

T1DM:

Type 1 diabetes mellitus

TOD:

Target organ damage

WCH:

White-coat hypertension

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Authors and Affiliations

  1. Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 7002, Cincinnati, OH, 45229, USA

    E. M. Urbina M.D., M.S.

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  1. E. M. Urbina M.D., M.S.
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Correspondence to E. M. Urbina M.D., M.S. .

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Editors and Affiliations

  1. University of Washington, Division of Pediatrics, Seattle Children's Hospital, Sand Point Way NE. 4800, Seattle, 98105, Washington, USA

    Joseph T. Flynn

  2. Harvard Medical School, Pediatric Nephrology Unit, MassGeneral Hospital for Children at MGH, Fruit St. 55, Boston, 02114, Massachusetts, USA

    Julie R. Ingelfinger

  3. Global Clinical Research, Bristol-Myers Squibb, Route 206 & Provinceline Road, Princeton, 08543, New Jersey, USA

    Ronald J. Portman

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Urbina, E.M. (2013). Ambulatory Blood Pressure: Methodology and Norms in Children. In: Flynn, J., Ingelfinger, J., Portman, R. (eds) Pediatric Hypertension. Clinical Hypertension and Vascular Diseases. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-490-6_11

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