Evaluation of the Hypertension with Ambulatory Blood Pressure Monitoring in Obese Children
- 1. Department of Pediatrics, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Türkiye.
- 2. Department of Pediatric Endocrinology, Ankara Training and Research Hospital, Ankara, Türkiye.
- 3. Department of Pediatric Emergency, Ankara Training and Research Hospital, Ankara, Türkiye.
- 4. Güven Hastanesi., Çocuk Nefroloji Kliniği, Ankara, Türkiye [Department of Pediatric Nephrology, Güven Hospital, Ankara, Türkiye.
Description
Özet
Çalışmada anlık kan basıncı ölçümleri <95 persentil olan obez ergenlerde ambulatuar kan basıncı izlemi (AKBM) ile kan basıncının değerlendirilmesi ve vücut kitle indeksinin kan basıncı üzerine etkisinin araştırılması amaçlandı. Çalışma Ankara Eğitim ve Araştırma Hastanesi Çocuk Endokrinoloji polikliniğine başvuran 53 obez ve 41 normal ağırlıklı hastada ileriye dönük olarak yürütülmüştür. Çalışmaya 12-16 yaş arası, 53 obez ve 41 sağlıklı olgu dahil edildi. Obez ve kontrol gruplarının AKBM değerleri karşılaştırıldığında obez olguların ortalama sistolik kan basıncı 123.0±4.7 mmHg, ortalama gündüz sistolik kan basıncı 125.4±4.7 mmHg ve ortalama gece sistolik kan basıncı 107.0±5.9 mmHg olarak saptandı. Kontrol grubunda bu değerler sırasıyla 113.5±5.5 mmHg, 115.5±4.7 mmHg ve 98.3±4.2 mmHg olarak saptandı (p<0.001). Aynı şekilde obez olguların ortalama diyastolik kan basıncı, ortalama gündüz diyastolik kan basıncı ve ortalama gece diyastolik kan basıncı kontrol grubuna göre istatistiksel olarak yüksek saptandı (p<0.001). Obez olgularda tam gün, gündüz ve gece, sistolik ve diyastolik kan basıncı yükü, kontrol grubuna göre daha yüksek bulundu (p<0.001). Obez olguların %7.5‘inin (n=4) non-dipper olduğu saptanırken, kontrol grubunda ise non-dipper olgu saptanmadı. Vücut kitle indeksi (VKİ) ile ortalama kan basınçları arasındaki ilişki değerlendirildiğinde VKİ arttıkça ortalama kan basınçlarının pozitif yönde arttığı tespit edildi (p<0.05); tam gün sistolik–diyastolik kan basıncı yükü ile ise ilişki saptanmadı (p>0.05). Anlık kan basıncı ölçümleri <95 persentil olan obez ergenlerde AKBM ile kan basınçları ve kan basıncı yükü yüksek saptandı. Bu nedenle obez ergenlerde erken dönemde kan basıncı yüksekliği saptanarak ileri dönem komplikasyonları önlenebilecektir.
Abstract
In this study, it was aimed to evaluate blood pressure by ambulatory blood pressure monitoring (ABPM) and to investigate the effect of body mass index on blood pressure in obese adolescents whose instantaneous blood pressure measurements were <95th percentile. The study was performed prospectively in 53 obese and 41 normal weight patients who applied to Ankara Training and Research Hospital Pediatric Endocrinology outpatient clinic. Fifty-three obese and 41 healthy participants aged 12-16 years were included in the study. When the ABPM values of the obese and control groups were compared, the mean systolic blood pressure of obese subjects was found to be 123.0±4.7 mmHg, the mean daytime systolic blood pressure was 125.4±4.7 mmHg, and the mean nighttime systolic blood pressure was 107.0±5.9 mmHg. In the control group, these values were 113.5±5.5 mmHg, 115.5±4.7 mmHg and 98.3±4.2 mmHg, respectively (p <0.001). Likewise, the mean diastolic blood pressure, mean daytime diastolic blood pressure and mean night diastolic blood pressure in obese patients were statistically higher than the control group (p<0.001). Systolic and diastolic blood pressure burden of full day, day and night were found to be higher than the control group in obese patients (p<0.001). While 7.5% of the obese cases (n=4) were found to be non-dipper, non-dipper case was not found in the control group. When the relationship between body mass index (BMI) and mean blood pressure was evaluated, it was found that mean blood pressure increased positively as BMI increased (p<0.05). However, no relationship was found with full-day systolic-diastolic blood pressure load (p>0.05). Obese adolescents whose instantaneous blood pressure measurements were <95 percentile had high blood pressure and blood pressure load with ABPM. Therefore, high blood pressure can be detected in the early period in obese adolescents and further complications can be prevented.
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