Is Daytime Systolic Load an Important Risk Factor for Target Organ Damage in Pediatric Hypertension?

The aim of this study was to compare ambulatory blood pressure (BP) monitoring ( ABPM ) data and determine which hypertension type is a risk factor in target organ damage. A total of 82 children (47 boys) with suspected hypertension based on office BP measurements and considered hypertensive by ABPM were studied . Target organ damage included the following: 35.3% hypertensive retinopathy, 25.6% microalbuminuria, 15.8% increased left ventricular mass index, 29.2% increased carotid intima‐media thickness ( cIMT ), 24.3% high augmentation index (AIx), and 19.5% high pulse wave velocity ( PWV ). The association between BP load, PWV , and cIMT was statistically significant. There were significant correlations between daytime systolic BP load, PWV , AIx , and cIMT . A statistically significant difference was also detected between nighttime systolic BP load, PWV , and cIMT values and nighttime diastolic BP load levels and values of AIx and cIMT . There was also a statistically significant difference between the high level of nighttime diastolic BP load and cIMT . The authors found that target organ damage was seen more often in children with primary hypertension who had systolic loads.