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Abstract: TH-PO495

Prevalence of Masked Hypertension and Its Association with Target Organ Damage in Children: A Systematic Review and Meta-Analysis

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Yu, Andrew, University of Alberta Faculty of Science, Edmonton, Alberta, Canada
  • Chung, Jason, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
  • Robinson, Cal, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Sheffield, Lauren, McMaster University, Hamilton, Ontario, Canada
  • Paramanathan, Prathayini, All Saints University School of Medicine, Roseau, Saint George, Dominica
  • Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Parekh, Rulan S., Women's College Hospital, Toronto, Ontario, Canada
  • Sinha, Manish, Evelina London Children's Hospital, London, London, United Kingdom
  • Dionne, Janis M., BC Children's Hospital, Vancouver, British Columbia, Canada
  • Chanchlani, Rahul, McMaster Children's Hospital, Hamilton, Ontario, Canada
Background

We investigate the prevalence of pediatric masked hypertension (MH) in children with various comorbid conditions and compare the risk of target organ damage in children with MH and normotensive children.

Methods

A systematic literature search on nine databases included English publications from 1974-2023. MH was defined based on ambulatory blood pressure monitoring. LVMI was indexed to subject height and body surface area (g/m2.7). LVH was defined by the 95th percentile pediatric reference range, or a pediatric or adult cut-off. Correlation coefficients were transformed and pooled using a random effects model.

Results

Of 8996 screened studies, 12 studies and 2028 children were included. MH prevalence was highest among those with chronic kidney disease (CKD) (18%), congenital cardiac conditions (24%), obesity (18%), and solid-organ or stem-cell transplant (24%). LVMI was elevated in the MH group (mean=35.48 g/m2.7) compared to the normotensive group (mean=31.10 g/m2.7), with a mean difference of LVMI was 4.06 g/m2.7 (95% CI:2.78-5.33) (fig). MH children were at 2.37 (95% CI: 1.41, 3.97) increased odds of LVH compared to normotensive children.

Conclusion

MH is common among children with congenital cardiac conditions, solid organ or stem-cell transplant, CKD, and obesity, and is associated with increased risk of LVH. These findings emphasize the importance of early screening, diagnosis, and treatment of hypertension in these high-risk children.