Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices

<b>Background:</b> Ambulatory blood pressure monitoring (ABPM) is increasingly recognized as a more reliable indicator of blood pressure status in children than clinic-based measurements, with superior predictive value for cardiovascular morbidity and mortality. However, evidence on the...

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Main Authors: Sulaiman K. Abdullah, Ibrahim A. Sandokji, Aisha K. Al-Ansari, Hadeel A. Alsubhi, Abdulaziz Bahassan, Esraa Nawawi, Fawziah H. Alqahtani, Marwan N. Flimban, Mohamed A. Shalaby, Jameela A. Kari
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Language:English
Published: MDPI AG 2025-07-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/7/939
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author Sulaiman K. Abdullah
Ibrahim A. Sandokji
Aisha K. Al-Ansari
Hadeel A. Alsubhi
Abdulaziz Bahassan
Esraa Nawawi
Fawziah H. Alqahtani
Marwan N. Flimban
Mohamed A. Shalaby
Jameela A. Kari
author_facet Sulaiman K. Abdullah
Ibrahim A. Sandokji
Aisha K. Al-Ansari
Hadeel A. Alsubhi
Abdulaziz Bahassan
Esraa Nawawi
Fawziah H. Alqahtani
Marwan N. Flimban
Mohamed A. Shalaby
Jameela A. Kari
author_sort Sulaiman K. Abdullah
collection DOAJ
description <b>Background:</b> Ambulatory blood pressure monitoring (ABPM) is increasingly recognized as a more reliable indicator of blood pressure status in children than clinic-based measurements, with superior predictive value for cardiovascular morbidity and mortality. However, evidence on the clinical utility of ABPM-derived indices, such as pulse pressure (PP), pulse pressure index (PPI), rate pressure product (RPP), ambulatory arterial stiffness index (AASI), and average real variability (ARV), remains underexplored in the pediatric population, particularly among children with chronic kidney disease (CKD). <b>Objective:</b> To evaluate the correlation between ABPM-derived indices in children, with a subgroup analysis comparing those with and without CKD. Secondary objectives included identifying factors associated with AASI and ARV and assessing their utility in cardiovascular risk stratification. <b>Methods:</b> In this bicentric cross-sectional study, 70 children (41 with CKD and 29 controls) were enrolled. ABPM indices (PP, PPI, RPP, AASI, and ARV) were calculated, and both descriptive and inferential statistical analyses, including linear regression, were performed. <b>Results:</b> Systolic and diastolic hypertension were significant predictors of elevated ARV (<i>p</i> < 0.05), while body mass index (BMI) and glomerular filtration rate (GFR) were positively associated with AASI (<i>p</i> < 0.05). Use of angiotensin-converting enzyme inhibitors (ACEIs) was associated with reduced arterial stiffness (<i>p</i> = 0.02). Significant differences were observed in weight, BMI, PP, and PPI between the CKD and non-CKD groups, with ABPM demonstrating greater sensitivity in detecting vascular health markers. <b>Conclusions:</b> ABPM-derived indices, particularly PP, PPI, and ARV, show promise in improving cardiovascular risk assessment in children. These findings support the broader use of ABPM metrics for refined cardiovascular evaluation, especially in pediatric CKD.
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spelling doaj-art-e3e98fa92bd14472ad344c5be20512d12025-08-20T03:32:26ZengMDPI AGChildren2227-90672025-07-0112793910.3390/children12070939Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure IndicesSulaiman K. Abdullah0Ibrahim A. Sandokji1Aisha K. Al-Ansari2Hadeel A. Alsubhi3Abdulaziz Bahassan4Esraa Nawawi5Fawziah H. Alqahtani6Marwan N. Flimban7Mohamed A. Shalaby8Jameela A. Kari9Pediatric Department, College of Medicine, Taibah University, Madinah 41541, Saudi ArabiaPediatric Department, College of Medicine, Taibah University, Madinah 41541, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Department, King Abdulaziz University Hospital, Jeddah 21589, Saudi ArabiaKhamis Mushait Maternity & Children Hospital, Khamis Mushait 62454, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Nephrology Center of Excellence, Pediatric Nephrology Unit, Pediatric Department, King Abdulaziz University, Jeddah 21589, Saudi Arabia<b>Background:</b> Ambulatory blood pressure monitoring (ABPM) is increasingly recognized as a more reliable indicator of blood pressure status in children than clinic-based measurements, with superior predictive value for cardiovascular morbidity and mortality. However, evidence on the clinical utility of ABPM-derived indices, such as pulse pressure (PP), pulse pressure index (PPI), rate pressure product (RPP), ambulatory arterial stiffness index (AASI), and average real variability (ARV), remains underexplored in the pediatric population, particularly among children with chronic kidney disease (CKD). <b>Objective:</b> To evaluate the correlation between ABPM-derived indices in children, with a subgroup analysis comparing those with and without CKD. Secondary objectives included identifying factors associated with AASI and ARV and assessing their utility in cardiovascular risk stratification. <b>Methods:</b> In this bicentric cross-sectional study, 70 children (41 with CKD and 29 controls) were enrolled. ABPM indices (PP, PPI, RPP, AASI, and ARV) were calculated, and both descriptive and inferential statistical analyses, including linear regression, were performed. <b>Results:</b> Systolic and diastolic hypertension were significant predictors of elevated ARV (<i>p</i> < 0.05), while body mass index (BMI) and glomerular filtration rate (GFR) were positively associated with AASI (<i>p</i> < 0.05). Use of angiotensin-converting enzyme inhibitors (ACEIs) was associated with reduced arterial stiffness (<i>p</i> = 0.02). Significant differences were observed in weight, BMI, PP, and PPI between the CKD and non-CKD groups, with ABPM demonstrating greater sensitivity in detecting vascular health markers. <b>Conclusions:</b> ABPM-derived indices, particularly PP, PPI, and ARV, show promise in improving cardiovascular risk assessment in children. These findings support the broader use of ABPM metrics for refined cardiovascular evaluation, especially in pediatric CKD.https://www.mdpi.com/2227-9067/12/7/939pediatric hypertensionambulatory blood pressure monitoringcardiovascular riskarterial stiffnessblood pressure variabilitychronic kidney disease
spellingShingle Sulaiman K. Abdullah
Ibrahim A. Sandokji
Aisha K. Al-Ansari
Hadeel A. Alsubhi
Abdulaziz Bahassan
Esraa Nawawi
Fawziah H. Alqahtani
Marwan N. Flimban
Mohamed A. Shalaby
Jameela A. Kari
Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
Children
pediatric hypertension
ambulatory blood pressure monitoring
cardiovascular risk
arterial stiffness
blood pressure variability
chronic kidney disease
title Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
title_full Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
title_fullStr Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
title_full_unstemmed Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
title_short Ambulatory Blood Pressure Monitoring in Children: A Cross-Sectional Study of Blood Pressure Indices
title_sort ambulatory blood pressure monitoring in children a cross sectional study of blood pressure indices
topic pediatric hypertension
ambulatory blood pressure monitoring
cardiovascular risk
arterial stiffness
blood pressure variability
chronic kidney disease
url https://www.mdpi.com/2227-9067/12/7/939
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