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RELATIONSHIP OF HOME AND AMBULATORY BLOOD PRESSURE WITH TARGET ORGAN DAMAGE IN CHILDREN AND ADOLESCENTS: PP.3.109

Objective: To compare home blood pressure (HBP) measurements versus ambulatory (ABP) and clinic (CBP) measurements in terms of their association with end-organ damage in children and adolescents. Methods: Eighty-three children and adolescents (mean age 13.1 ± 3 years, 54 boys) referred for elevated CBP had measurements of CBP (1 visit), HBP (6 days) and ABP (24-hours). Seventy-eight participants were also assessed with carotid-femoral pulse-wave velocity (PWV) and 55 with echocardiography. Results: Average CBP was 122.3 ± 15.1/70.9 ± 12.9 mmHg (systolic/diastolic), HBP 121.4 ± 11.4/69.4 ± 6.5 mmHg and 24-hour ABP 119.1 ± 12.3/66.6 ± 6.2 mmHg. Systolic BP was significantly correlated with PWV with r coefficients in decreasing order as follows: 0.41 for HBP, 0.36 for CBP and 0.35 for 24-hour ABP (0.34 for daytime; 0.33 for nighttime) (all p < 0.01). Only diastolic HBP was significantly correlated with PWV (r = 0.24, p = 0.03). Left ventricular mass (LVM) was also correlated with systolic BP (r = 0.60 for 24-hour, 0.57 daytime, 0.55 nighttime ABP, 0.51 for HBP, 0.44 for CBP; all p < 0.01). In multivariate stepwise regression analysis with age, gender, body mass index (BMI), CBP, HBP and ABP 24-hour, daytime and nighttime systolic BPs as independent variables, PWV was predicted only by systolic HBP and BMI, whereas LVM was predicted by age, 24-hour systolic ABP and BMI. Conclusions: In children and adolescents ABP as well as HBP measurements appear to be superior to the conventional CBP measurements in predicting the presence of subclinical end-organ damage.