The role of ambulatory blood pressure monitoring in the evaluation of adolescent hypertension induced by exercise
We performed 24-hour ambulatory blood pressure monitoring in a group of adolescents with hypertension induced by dynamic exercise. Ten patients with a mean age of 15.1 years (12–18) developed systolic blood pressure greater than 240 mmHg after 15 minutes of graded exercise (initial load 400 KPM; increased every 3 minutes to 1000 KPM, then 1 minute at 1800 KPM) on a stationary bicycle. Ambulatory blood pressure monitoring was performed using a Del Mar Avionics PIII recorder with recordings taken every 7½ minutes for 24 hours. Data was expressed as the mean systolic and diastolic blood pressure for each hour of recording, for the total 24 hour recording period, for the period from 8 a.m. to 8 p.m. (daytime), and for the period from 8 p.m. to 8 a.m. (night-time). Variability was defined as one standard deviation of the mean systolic and diastolic blood pressure obtained in each recording period. There was little inter-individual variation in mean hourly blood pressure and the difference between mean hourly readings was not significant. Mean 24-hour ambulatory blood pressure was 130.2/80.7 mmHg. Mean 24-hour systolic variability was 18.3 mmHg and diastolic variability was 12.9 mmHg. There was no significant change in blood pressure between daytime and night-time recording periods. There was no significant difference in variability between day and night. The normal fall in blood pressure seen during the early morning hours in adults and normotensive adolescents and the lack of reduction in variability seen in the night-time in the same groups suggested abnormal circadian variation. In adolescents with systolic hypertension induced by dynamic exercise, ambulatory blood pressure monitoring may be used as a predictive marker of early adult essential hypertension.
KeywordsMercury Catecholamine Berman
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