Comparison between casual blood pressure and ambulatory blood pressure monitoring parameters in healthy and hypertensive adolescents.

Casual blood pressure measurements were compared with mean ambulatory blood pressure values during wakefulness and sleep in 45 normotensive and 30 hypertensive adolescents of both sexes aged 10-18 years. Two sets of auscultatory casual blood pressure were obtained, one in a pediatric office setting (office blood pressure), performed by the physician, and one in the ambulatory blood pressure monitoring (ABPM) unit, performed by a trained nurse, prior to the initiation of ABPM (pre-ABPM blood pressure). In normotensive and hypertensive subjects of both sexes, the mean office systolic blood pressure (SBP) was lower than the mean pre-ABPM SBP, and the mean office diastolic blood pressure (DBP) was lower than the mean pre-ABPM DBP. In normotensive participants, the mean pre-ABPM SBP/DBP was lower than the mean ABPM SBP/DBP while awake, the mean ABPM SBP/DBP during sleep being lower than the mean ABPM SBP/DBP values while awake and the mean pre-ABPM SBP/DBP. No statistical difference was demonstrated between the mean office SBP and the mean ABPM SBP during sleep, the mean ABPM DBP during sleep being lower than the mean office DBP. The hypertensive adolescents presented a blood pressure profile similar to that of the normotensive group, albeit shifted upwards, with no significant difference between the mean pre-ABPM SBP and the mean ABPM SBP while awake but a higher mean pre-ABPM DBP than mean ABPM DBP while awake. This study suggests that, by evaluating the casual blood pressure in different environment/observer situations, the power of casual blood pressure to predict inadequate blood pressure control, manifested as abnormal ABPM parameters, can be enhanced. Our data indicate ABPM to be the method of choice for the early diagnosis and adequate follow-up of adolescent hypertension.

White coat hypertension in adolescents.

BACKGROUND: Although white coat hypertension (WCH) seems to occur in 20% or more of the adult hypertensive population, this clinical condition has rarely been described in adolescents. DESIGN: Routine use of ambulatory blood pressure monitoring (ABPM) procedure as part of the investigation of arterial hypertension in adolescents. METHODS: Office blood pressure was checked after 5 minutes of rest in the seated position by the auscultation method and ABPM was performed with oscillometrical equipment (SpaceLabs 90207, Redmond, Washington, USA). RESULTS: In the present study 6 adolescents (5 females, 3 white), suspected to suffer from arterial hypertension as judged by office blood pressure measurements, mean age 15.1 years (12.2 - 17.7), mean height 164.5 cm, mean weight 77.2 kg, mean body mass index 28.8 kg/m2 (25 - 35.2), were diagnosed with WCH using ambulatory blood pressure monitoring (ABPM). CONCLUSION: White coat hypertension should also be considered in the evaluation of arterial hypertension in adolescents.

[Ambulatory blood pressure monitoring in normal adolescents]. / Monitorização ambulatorial da pressão arterial em adolescentes normais.

PURPOSE: To evaluate technical aspects of ambulatory blood pressure monitoring (ABPM) in normal adolescents. METHODS: Forty five normal adolescents (27 female), 10-18 years old. RESULTS: ABPM recordings showed a mean of 90% successful readings; 30% of the patients complained of sleep disruption related to the functioning of the ABPM monitor; the mean systolic, diastolic and heart rate fall during sleep was 13%, 23% and 24% respectively; the mean systolic and diastolic blood pressure load, while awake, was in male adolescents 25.4 +/- 27.7% and 11.8 +/- 14.6%, and in female adolescents, 17.5 +/- 18.7% and 11.8 +/- 11.4%, respectively; the mean systolic and diastolic blood pressure load, while asleep, was in male adolescents 15.4 +/- 22.9% and 2.8 +/- 4.9% and, in female adolescents, 10.5 +/- 18.2% and 1.8 +/- 2.7%, respectively; the mean diastolic values of the first two hours of recording were higher than the ones obtained during the rest of the hours of recording while awake; different mean systolic, diastolic and heart rate values were found during the afternoon and nocturnal sleep periods. CONCLUSION: ABPM was well accepted by the adolescent population, with good technical results.

[Relations among arm, arm muscle, arm fat areas and menarche in adolescents in the municipality of Botucatu]. / Relação entre área do braço, área do músculo, área de gordura do braço e a menarca em adolescentes do município de Botucatu.

The authors show the relations among arm circumference, arm muscle and arm fat areas with or without menarche, by carrying out an anthropometric study in 717 adolescents in the municipality of Botucatu. It must be emphasized that those adolescents who had already menstruated presented significantly higher nutritional indicators than those who had not menstruated yet. There was an increase in fat tissue and lean body mass in those adolescents who had already menstruated. Body changes might be expressed by calculating muscle and arm fat areas using triceps skinfold and arm circumference.

Vacinacao de adolescentes em atendimento ambulatorial. / Vaccination of adolescents in ambulatory care

O estudo apresentado tem por objetivo caracterizar a historia de vacinacao em grupo de 108 adolescentes atendidos em uma unidade ambulatorial a eles destinada. Observou-se que 77,8% dos adolescentes tinham vacinacao incompleta e que 52,8% nao tinham recebido esquema com as vacinas disponiveis nas instituicoes publicas de saude. Os dados chamam a atencao para falhas importantes na vacinacao de adolescentes contra difteria, tetano e paralisia infantil e aponta para a necessidade de identificar os adolescentes susceptiveis de contrair as molestias proprias da infancia