24-hour ABPM essential for the diagnosis of paediatric hypertension

Press Release - 20 October 2009

In the last decade the incidence of hypertension in children and adolescents has risen substantially and elevation of blood pressure during childhood and adolescence is more common than previously thought. However, this rise is not entirely explained by the increase in the prevalence of obesity. Furthermore, there is increasing awareness about paediatric hypertension leading to a more common approach to blood pressure measurement and subsequent hypertension diagnosis.

According to the 2009 European Society of Hypertension (ESH) recommendations for the management of elevated blood pressure in children and adolescents, 24-hour ABPM is now recognised as being indispensable to the diagnosis and management of paediatric hypertension. This method is particularly useful in unmasking blood pressure phenomena not readily apparent by office measurements, such as the non-dipping pattern, white coat hypertension and masked hypertension.

During the process of diagnosis, 24-hour ABPM is essential to confirm hypertension before starting drug treatment. This method is also useful for the assessment of the blood pressure profile in children with type-1 diabetes or chronic kidney disease and those with target organ damage. 24-hour ABPM is also recommended for the assessment of effective blood pressure control in treated subjects.

The diagnosis of hypertension in children and adolescents is based on normalcy tables for office blood pressure derived from large cross-sectional studies where the 95th percentiles for gender, age and height are provided as thresholds of normality. As in adults, repeated blood pressure measurements on several visits are needed to confirm the diagnosis in children and adolescents. However, the phenomena of white coat and masked hypertension are common in children and can only be detected by out-of-office blood pressure monitoring. Evidence on home blood pressure monitoring in children has only recently been reported, whereas ambulatory blood pressure monitoring (ABPM) has been extensively studied in the paediatric population.

As part of the continuous development of the dabl ABPM software and our commitment to bring new research and best practice to our users, we have already incorporated the ESH Paediatric Guidelines for 24-hour ABPM into the suite of dabl ABPM systems. This was done in conjunction with a member of the dabl Medical Advisory Board, Dr George Stergiou of Greece, a leading expert in this field who uses dabl ABPM Plus in his clinic for the diagnosis and management of 24-hour ABPM. We guarantee that our users have access to the most up-to-date evidenced-based system for the management of hypertension. We understand the difficulty of remaining up-to-date of current research so we make it easy for our users by automatically adding evidenced-based research for them.

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dabl Ltd is a leading developer and provider of expert healthcare management software systems and research tools for the prevention and management of stroke, heart attack, high blood pressure and a range of other cardiovascular conditions.

About dabl ABPM

dabl ABPM (Ambulatory Blood Pressure Measurement) offers accurate diagnosis, management and reporting of 24-hour ABPM. dabl ABPM is the only 24 hour blood pressure software to link to a range of validated devices and produce a one page interpreted report. Range includes: dabl ABPM; dabl ABPM Plus; dabl ABPM Pharmacy; and dabl ABPM Health Screening