Blood Pressure Variability and Left Ventricular Mass Index in Children

Clinical implications of blood pressure variability ( BPV ) on subclinical organ damage in children are unknown. The authors sought to explore the potential utility of two newly derived BPV indices: weighted standard deviation (w BPSD ) and real average variability ( ARV ), as well as two standard ambulatory blood pressure indices: average 24‐hour systolic blood pressure ( SBP ) and 24‐hour SBP load, to identify children at high risk for left ventricular (LV) hypertrophy ( LVH ). The study group consisted of 67 consecutive children who were referred to our institution for evaluation of suspected hypertension. LV mass was estimated by M ‐mode echocardiography using D evereux's formula according to the P enn convention and indexed for height 2.7 . We found a statistically significant, positive correlation between 24‐hour w BPSD and LV mass index ( LVMI ) (ρ=0.389; P =.002) and no correlation between 24‐hour ARV and LVMI ( P >.05). However, partial correlation analysis of 24‐hour w BPSD adjusted for body mass index ( BMI ) and LVMI showed only a weak correlation (ρ=0.3; P =.022). By using multiple linear regression analysis in a model with LVMI as a dependent variable and 24‐hour w BPSD , 24‐hour ARV, and BMI as independent variables, only BMI showed statistically significant independent positive associations with LVMI ( P =.028). Results of our study showed that currently used BPV indices (24‐hour w BPSD and 24‐hour ARV ) are not clinically reliable parameters to identify children at risk for LVH . Apparent contribution of the 24‐hour w BPSD parameter to LVMI is negligible and is secondary to its close correlation with BMI (ρ=0.335 P =.009).