Ambulatory blood pressure patterns in children and adolescents: Influence of renin-sodium profiles

G. A. Harshfield, D. A. Pulliam, B. S. Alpert, F. B. Stapleton, E. S. Willey, G. W. Somes

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

A renin-sodium nomogram for normotensive children and adolescents was developed at our institution. The ambulatory blood pressure patterns of subjects classified by the nomogram were then compared. A biracial sample of 159 children and adolescents were classified as having a low, intermediate, or high renin-sodium profile based on the relationship between their plasma renin activity and 24-hour urinary sodium excretion. Casual (106/58 vs 107/61 vs 106/62 mm Hg) and awake (116/69 vs 117/69 vs 116/70 mm Hg) blood pressure values were comparable among subjects with low, intermediate, and high renin-sodium profiles. Subjects with high renin-sodium profiles, however, had a smaller decline in systolic blood pressure with sleep than did subjects with low renin-sodium profiles (7 vs 11 mm Hg; P < .04), and higher diastolic blood pressure readings during sleep than subjects with intermediate renin-sodium profiles (65 vs 62 mm Hg; P < .05). Subjects with high renin-sodium profiles also had greater variance of diastolic blood pressure readings during sleep than either subjects with low renin-sodium profiles (P < .01) or those with intermediate renin-sodium profiles (P < .02). The blunted nocturnal decline and increased nocturnal variance of blood pressure among subjects with high renin-sodium profiles may be a marker or mechanism for the future development of essential hypertension.

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalPediatrics
Volume87
Issue number1
StatePublished - 1991

Keywords

  • adolescent blood pressure
  • ambulatory blood pressure
  • hypertension
  • renin-sodium profile

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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