RESUMEN
Arterial hypertension is a common pathology in children of different ages. The introduction of daily monitoring of blood pressure into the practice of pediatric cardiologists makes it possible to more accurately establish a diagnosis, determine the prognosis of the course of the disease and monitor treatment of hypertension. Objective - to assess the daily fluctuations of blood pressure in schoolchildren with arterial hypertension. 70 children of school age were examined. The main group (38 people) included children with high blood pressure, the control group included 32 clinically healthy children. All children underwent tonometry. The results for each child evaluated by percentile nomograms regarding age, gender and height. Verification of the diagnosis of arterial hypertension performed according to the recommendations of the American Academy of Pediatrics (AAP). In addition, children underwent ambulatory blood pressure monitoring. In 79% of children of the main group, the level of blood pressure assessed as arterial hypertension of the first stage, in 21% of children - arterial hypertension of the second stage. When conducting daily monitoring of blood pressure in 35 children (92.1%) of the main group, 2 peaks of systolic blood pressure observed: the first peak between 23:00 and 01:00 at night (from 5.5 to 18.8 mm Hg.), the second peak - in 28 children (73.7%) between 6.30 and 8.00 (from 6.8 to 10.1 mm Hg). At the same time, peaks in the level of diastolic blood pressure appeared in fewer children and were not so pronounced. In schoolchildren with stage 1 hypertension, a night peak observed in 60% of children, and a morning peak was in 22% of children. Among children with second stage of arterial hypertension a night peak observed in 100% persons and a morning peak observed in 72% of children. This suggests that the nocturnal peak of blood pressure may be a marker of the severity of arterial hypertension. In healthy children, there were no peaks in the rise in blood pressure. The presence of a non-dipper circadian profile in a school-age child in combination with the morning and/or night peak of systolic blood pressure can serve as a marker for the development of arterial hypertension. Therefore, such children must be attributed to the risk group for the development of this pathology.