Downloaded from http://adc.bmj.com/ on August 20, 2017 - Published by group.bmj.com
ADC Online First, published on August 16, 2017 as 10.1136/archdischild-2017-313298 PostScript
Letter
Hypertension outcomes and cardiovascular status in young adults with childhood-diagnosed white coat hypertension White coat hypertension (WCH) describes untreated subjects displaying elevated blood pressure (BP) in the clinical setting as opposed to normal ambulatory BP monitoring (ABPM) or BP taken at home.1 Adults with WCH are more likely to progress to sustained hypertension (SH) and to be at increased cardiovascular risk compared with normotensive subjects.2 Since it is unknown whether children with WCH progress to SH,3 we sought to determine hypertension outcomes using ABPM and cardiovascular status in young adults with childhood-diagnosed WCH. In a previous study conducted in Swedish healthy schoolchildren, we
identified 56 (3.8%) out of 1470 participants as having WCH, which was defined as systolic and/or diastolic casual BP >95th distribution adjusted height-related and sex-related percentile in three separate visits, but normal ABPM, that is, mean systolic and diastolic BP values during the awake and sleep period ≤95th distribution adjusted height-related and sex-related percentiles of the adapted reference standards.4 These children were invited to participate in a follow-up study and gave permission to be contacted after reaching adulthood. This is a prospective cohort study with ethical approval (2015/433-31/2). All participants provided informed written consent. Measurements of casual BP and ABPM were performed as previously described.4 ABPM thresholds for defining SH were ≥130 and/ or ≥80 mm Hg for 24 hours, ≥135 and/or ≥85 mm Hg for daytime, and ≥120 and/or ≥70 mm Hg for night-time, respectively.1 Echocardiography, the assessment of carotid intima-media thickness (cIMT) and vascular
stiffness were performed in accordance with the recommendations of the 2013 European Society of Hypertension.1 Left ventricular hypertrophy (LVH) was defined as left ventricular mass index >115 g/m2 for men and >95 g/m2 for women.1 Normal cIMT was defined as ≤0.9 mm.1 Normal carotid-femoral artery pulse wave velocity (PWV) was defined as ≤10 m/s.1 Differences between groups were compared with two-sample t-test. Fisher’s exact test was used to compare categorical variables. p Values
ADC Online First, published on August 16, 2017 as 10.1136/archdischild-2017-313298 PostScript
Letter
Hypertension outcomes and cardiovascular status in young adults with childhood-diagnosed white coat hypertension White coat hypertension (WCH) describes untreated subjects displaying elevated blood pressure (BP) in the clinical setting as opposed to normal ambulatory BP monitoring (ABPM) or BP taken at home.1 Adults with WCH are more likely to progress to sustained hypertension (SH) and to be at increased cardiovascular risk compared with normotensive subjects.2 Since it is unknown whether children with WCH progress to SH,3 we sought to determine hypertension outcomes using ABPM and cardiovascular status in young adults with childhood-diagnosed WCH. In a previous study conducted in Swedish healthy schoolchildren, we
identified 56 (3.8%) out of 1470 participants as having WCH, which was defined as systolic and/or diastolic casual BP >95th distribution adjusted height-related and sex-related percentile in three separate visits, but normal ABPM, that is, mean systolic and diastolic BP values during the awake and sleep period ≤95th distribution adjusted height-related and sex-related percentiles of the adapted reference standards.4 These children were invited to participate in a follow-up study and gave permission to be contacted after reaching adulthood. This is a prospective cohort study with ethical approval (2015/433-31/2). All participants provided informed written consent. Measurements of casual BP and ABPM were performed as previously described.4 ABPM thresholds for defining SH were ≥130 and/ or ≥80 mm Hg for 24 hours, ≥135 and/or ≥85 mm Hg for daytime, and ≥120 and/or ≥70 mm Hg for night-time, respectively.1 Echocardiography, the assessment of carotid intima-media thickness (cIMT) and vascular
stiffness were performed in accordance with the recommendations of the 2013 European Society of Hypertension.1 Left ventricular hypertrophy (LVH) was defined as left ventricular mass index >115 g/m2 for men and >95 g/m2 for women.1 Normal cIMT was defined as ≤0.9 mm.1 Normal carotid-femoral artery pulse wave velocity (PWV) was defined as ≤10 m/s.1 Differences between groups were compared with two-sample t-test. Fisher’s exact test was used to compare categorical variables. p Values
