Determining The Factors that Influence Blood Pressure Variability in Children with Essential Hypertension

Abstract

This study aimed to analyze blood pressure (BP) patterns, assess blood pressure variability (BPV), and its possible determinants in children with essential hypertension. The study group included 132 children with essential hypertension without antihypertensive therapy. Anthropometric and laboratory parameters were evaluated, office and ambulatory BP were measured. BPV was defined as the standard deviation of BP for the day and nighttime periods. In addition to classical statistical analysis, an unsupervised machine learning approach using the expected maximization algorithm was implemented to find groups of patients with similar characteristics. No differences in BPV were observed between sexes; however, boys had higher levels of creatinine, serum glucose, and uric acid despite similar body mass index values. There was a significant correlation between the Zscore for body mass index and daytime systolic BPV (r=0.19, p<0.05). Nighttime BPV significantly correlated with total cholesterol and uric acid levels. Within the male population, two clusters were found. The subjects in Cluster 2 had higher daytime and nighttime systolic and diastolic BP values, total cholesterol, triglycerides, and nighttime systolic and diastolic BPV. Our results suggest that the clustering of metabolic factors influences BPV in untreated children with essential hypertension, which may be a sex-specific effect in males.

Keywords

• Blood pressure variability
• Hypertension
• Ambulatory blood pressure monitoring