夜间血压降低幅度的减少和持续夜间高血压是继发性高血压的特有标志

• 作 者: Seeman T. Palyzová D. Du■ek J. Janda J. 郭战宏
• 机 构: Department of Pediatrics University Hospital Motol Charles University Prague V′Uvalu 84 15006 Pragu
• 出 处: 世界核心医学期刊文摘(儿科学分册)
• 发表日期: 2006年02期
• 关键词: 继发性高血压 夜间血压 原发性高血压 非杓型 舒张压 收缩压 动态血压 夜间收缩压 血压 研究设计

Objective: To investigate with the use of ambulatory blood pressure (BP) monitoring whether nocturnal BP dip and nighttime BP values are different in children with untreated primary and secondary hypertension. Study design: Ambulatory BP monitoring studies from 145 children with untreated hypertension were retrospectively analyzed. Forty-five children had primary hypertension and 100 children had secondary hyperten sion. Results: Children with secondary hypertension had lower nocturnal BP dip for systolic and diastolic BP in comparison to children with primary hypertension (8% ± 5% vs 14% ± 4% for systolic and 14% ± 7% vs 22% ± 5% for diastolic BP, P < .0001 for both). Eleven percent of children with primary hypertension were classified as nondipper (BP dip < 10% ) for systolic BP and no child for diastolic BP; on the contrary, in children with secondary hypertension, 65% were nondippers for systolic and 21% for diastolic BP. Nocturnal systolic and diastolic BP loads were significantly greater in children with secondary hypertension than in those with primary hypertension. Conclusions: Reduced nocturnal BP dip and sustained nighttime BP elevation are specific markers of secondary hypertension in children with untreated hypertension. Children with blunted nocturnal BP dip or sustained nighttime hypertension should be thoroughly investigated searching for the underlying cause of hypertension.

Objective: To investigate with the use of ambulatory blood pressure (BP) monitoring whether nocturnal BP dip and nighttime BP values ​​are different in children with untreated primary and secondary hypertension. Study design: Ambulatory BP monitoring studies from 145 children with untreated hypertension were retrospectively analyzed Results: Children with secondary hypertension had lower nocturnal BP dip for systolic and diastolic BP in comparison to children with primary hypertension (8% ± 5% vs 14% ± 4 % for systolic and 14% ± 7% vs 22% ± 5% for diastolic BP, P <.0001 for both). Eleven percent of children with primary hypertension were classified as nondipper (BP dip <10%) for systolic BP and no child for diastolic BP; on the contrary, in children with secondary hypertension, 65% were nondippers for systolic and 21% for diastolic BP. Nocturnal systolic and diastolic BP loads were significant ntly greater in children with secondary hypertension than in those with primary hypertension. Conclusions: Reduced nocturnal BP dip and sustained nighttime BP elevation are specific markers of secondary hypertension in children with untreated hypertension. Children with blunted nocturnal BP dip or sustained nighttime hypertension should be thoroughly investigated searching for the underlying cause of hypertension.