The Association of Obesity with Non-Dipping Status and Laboratory Biomarkers in Hypertensive Children

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Abstract

Objective:

To investigate the 24-h ambulatory blood pressure monitoring (ABPM) and laboratory markers associated with target organ damage and to evaluate the relationship between obesity and non-dipping status on ABPM in children with essential hypertension (HT).

Methods:

We conducted a study using a database of patients aged 5-18 years. Inclusion criteria were: subjects where records documented a blood pressure >95^th percentile for age, sex, and height by a referring physician had ABPM for diagnosis. The data of target organ damage, body mass index (BMI), and laboratory parameters were collected.

Results

This study included 175 patients (48 lean, 127 overweight+obese). Thirty-seven patients had white coat hypertension (WCH), 29 patients had Pre-HT, and 109 patients had HT. There were no significant differences in mean age, gender, or mean BMI of children between the groups (p>0.05). Non-dipper status and uric acid level were significantly higher in overweight+obese patients compared to normal weight patients (55.9% vs. 39.5%, p=0.04, 4.9±1.4 vs. 5.3±1.3, p=0.03). Nine patients had left ventricular hypertrophy (2 WCH, 7 HT) and 17 patients had retinopathy (4 WCH, 2 Pre-HT, 11 HT).

Discussion

Obese patients should be screened for HT by ABPM. WCH and Pre-HT are also not innocent and cause significant morbidity.