Prognostické aspekty ambulantního monitorování krevního tlakuse zřetelem na dětský věk

Prognostic Aspects of Ambulatory Monitoring of the Blood Pressure with Regard to Child Age

As compared with common measurement of causal blood pressure (BP) in the doctor’s office, ambulatorymonitoring of the BP (ABPM) provides information on BP readings in the patient’s usual environment throughout24 hours. Trials in adult patients indicate that this information can correlate better with prognostic indicators ofcardiovascular morbidity or injury of target organs.White coat hypertension (WCH) is a condition where a patient with elevated BP readings in the office hasnormal ambulatory BP readings. Contrary to fixed hypertension, the prognosis of WCH is comparable withnormotension. WCH is found relatively frequently also in child patients. For this age group however so far theprognostic definition of this clinical entity is lacking.Investigations of adults indicate that impaired dipping of BP during the night is associated with adverseprognostic indicators. In the child population this phenomenon is found relatively frequently in patients withsecondary hypertension.The application of ABPM as a supplementary examination of hypertensive patients in child and adolescent agecan reduce unnecessary examination and treatment in cases of diagnosed WCH. In patients with diseases whichcan lead to the development of secondary hypertension ABMP makes a more sensitive diagnosis of hypertensionpossible (in particular during the night) and also more accurate pharmacological treatment.

Key words:
blood pressure, ambulatory monitoring of blood pressure, child age