The Association of Obesity with Non-Dipping Status and Laboratory Biomarkers in Hypertensive Children

Objective: To investigate the 24-h ambulatory blood pressure monitoring (ABPM) and laboratory markers associated with target organ damage and to evaluate the relationship between obesity and non-dipping status on ABPM in children with essential hypertension (HT). Methods: We conducted a study using a database of patients aged 5-18 years. Inclusion criteria were: subjects where records documented a blood pressure >95th percentile for age, sex, and height by a referring physician had ABPM for diagnosis. The data of target organ damage, body mass index (BMI), and laboratory parameters were collected. Results: This study included 175 patients (48 lean, 127 overweight+obese). Thirty-seven patients had white coat hypertension (WCH), 29 patients had Pre-HT, and 109 patients had HT. There were no significant differences in mean age, gender or mean BMI of children between the groups (p>0.05). Non-dipper status and uric acid level were significantly higher in overweight+obese patients compared to normal weight patients (55.9% vs. 39.5%, p=0.04, 4.9±1.4 vs. 5.3±1.3, p=0.03). Nine patients had left ventricular hypertrophy (2 WCH, 7 HT) and 17 patients had retinopathy (4 WCH, 2 Pre-HT, 11 HT). Discussion: Obese patients should be screened for HT by ABPM. WCH and Pre-HT are also not innocent and cause significant morbidity.