[Ambulatory monitoring of blood pressure--focus on childhood]

Abstract

Conventional office measurements of blood pressure (BP) are limited in their ability to assess long term hemodynamic load on cardiovascular system. The ambulatory blood pressure monitoring (ABPM) offers the advantage of providing multiple blood pressure measurements from a subject's normal environment during his normal activities, thereby revealing important patterns of blood pressure during the whole 24-hour period. Results of ABPM have much better correlation with end organ damage than casual BP and provide more sensitive data of ultimate prognosis. There is much better long-term reproducibility of ambulatory blood pressure compared with conventional office BP measurements. The phenomenon of "white coat" hypertension (WCH) defined as mean office BP readings in the hypertensive range but ambulatory blood pressure (ABP) readings in the normal range represents probably a benign entity not requiring pharmacological treatment. Based on normal population of school children and adolescents the percentiles of ABP have been recently established and patterns of ABP have been studied in children in various clinical settings. WCH has been recognized in childhood and its prevalence seems to be higher comparing with adult population. ABPM seems to be an effective and well tolerated tool in evaluating BP in children and adolescents helping to identify those who need careful checkup and treatment.