Home blood pressure monitoring in paediatric chronic hypertension

Blood pressure (BP) measurement is the basis for thediagnosis and management of arterial hypertension. Theaim of this study was to compare BP measurementsperformed in the office and at home (home bloodpressure monitoring, HBPM) in children and adoles-cents with chronic arterial hypertension. HBPM wasperformed by the patient or by his/her legal guardian.During a 14-day period, three BP measurements wereperformed in the morning or in the afternoon (daytimemeasurement) and in the evening (night-time measure-ment), with 1-min intervals between measurements,totalling six measurements per day. HBPM was definedfor systolic blood pressure (SBP) and diastolic bloodpressure (DBP) values. HBPM was evaluated in 40patients (26 boys), mean age of 12.1 years (4–18 years).SBP and DBP records were analysed. The meandifferences between average HBP and doctor’s officeBP were 0.6±14 and 4±13mmHg for SBP and DBP,respectively. Average systolic HBPM (daytime andnight-time) did not differ from average office BP, anddiastolic HBPM (daytime and night-time) was statisti-cally lower than office BP. The comparison of individualBP measurements along the study period (13 days) bys.d. of differences shows a significant decline only forDBP values from day 5, on which difference tends todisappear towards the end of the study. Mean daytimeand night-time SBP and DBP values remained stablethroughout the study period, confirming HBPM as anacceptable methodology for BP evaluation in hyperten-sive children and adolescents.Journal of Human Hypertension (2009) 23, 464–469;doi:10.1038/jhh.2008.167; published online 12 March 2009Keywords: home blood pressure monitoring; chronic hypertension; oscillometric blood pressure monitors; children;adolescents