Jurko Alexander, Jurko Alexander ml., Ďurdík Peter
Introduction: Although intensively discussed and finally accepted in recent years, white coat hypertension (wch) still raises the question of the benefit of diagnosing it in pediatric patients as its possible link with the subsequent essential hypertension is not clear yet. The aim of the study: Selected use of ambulatory blood pressure monitoring to identify children with white coat hypertension, thus avoiding unnecessary diagnostic testing and treatment of these children. Methods: White coat hypertension is defined as BP levels that are the 95th percentile or higher when measured in the physician’s office or clinic but 24-hour blood pressure readings in the normal range (average BP < 90th percentile). 160 children (aged 12 to 19 years) participated in the study. Based on office systolic and diastolic blood pressure measurements and 24-hour ambulatory blood pressure monitoring, subjects were placed into one of two groups: I. hypertensive (Hts) and II. white coat hypertensive (Wch). Results: Forty three percent (68 children) of 160 subjects with systolic or diastolic blood pressures greater than or equal to 95th percentile were reclassified as white coat hypertension; 92 (57 %) remained hypertensive. The ambulatory blood pressure monitoring patterns of white coat hypertensive patients were significantly different from those of hypertensive patients. The mean values of systolic, diastolic and mean arterial pressure were significantly higher in children with essential hypertension than in the group with white coat hypertension. We evaluated the differences in the frequency of the heart between children with white coat hypertension and the group of children with systemic hypertension. We found statistically significant differences in heart rate between both groups only during night (p ≤ 0.01). Conclusions: This study documented the existence of white coat hypertensive children and showed that white coat hypertensive children were significantly different from hypertensive children on the basis of 24-hour ambulatory blood pressure monitoring data.