Brief Article
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World J Cardiol. Aug 26, 2010; 2(8): 251-256
Published online Aug 26, 2010. doi: 10.4330/wjc.v2.i8.251
Hypertension and obstructive sleep apnea in Caucasian children
Valerie Kirk, Julian Midgley, Michael Giuffre, Paul Ronksley, Alberto Nettel-Aguirre, Abdulla Al-Shamrani
Valerie Kirk, Abdulla Al-Shamrani, Division of Respiratory Medicine, University of Calgary, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
Julian Midgley, Division of Nephrology, University of Calgary, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
Michael Giuffre, Division of Cardiology, University of Calgary, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
Paul Ronksley, Alberto Nettel-Aguirre, Department of Pediatrics and Community Health Sciences Department, University of Calgary, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
Author contributions: Kirk V, Midgley J, Giuffre M, Nettel-Aguirre A and Al-Shamrani A designed the research; Ronksley P and Al-Shamrani A performed the research; Nettel-Aguirre A and Kirk V analyzed the data; Kirk V, Midgley J, Giuffre M and Nettel-Aguirre A wrote the paper; all authors reviewed, edited and approved the manuscript.
Supported by Partially funded by the Alberta Children’s Hospital Foundation
Correspondence to: Valerie Kirk, MD, FRCPC, Division of Respiratory Medicine, University of Calgary, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada. val.kirk@albertahealthservices.ca
Telephone: +1-403-9552923 Fax: +1-403-9553085
Received: May 20, 2010
Revised: July 13, 2010
Accepted: July 20, 2010
Published online: August 26, 2010
Abstract

AIM: To evaluate the prevalence of hypertension and/or left ventricular hypertrophy (LVH) in children with a diagnosis of obstructive sleep apnea (OSA).

METHODS: A cross-sectional case series of consecutive, otherwise healthy children aged > 4 years, with polysomnography-proven OSA [apnea hypopnea index (AHI) > 1.5/h] is described. Echocardiography was performed on all subjects and left ventricular mass was calculated. Study subjects underwent additional investigation with 24-h ambulatory blood pressure (BP) monitoring.

RESULTS: Thirty children (21 males) were studied. Mean age was 8.9 years. Mean body mass index was 19.87 kg/cm2. Mean AHI was 14.3/h. 10/30 (33%) of the study population met criteria for pre-hypertension (n = 3) or masked hypertension (n = 7) based on standard ambulatory monitoring criteria. All 10 children had systolic hypertension throughout the night with 5 of these also having elevated daytime systolic readings. There was a relationship between AHI and BP showing an increase of 1.162 percentile units in mean diastolic night BP (age, gender and height specific) per unit increase in AHI (P = 0.018). There were no subjects with LVH and/or right ventricular hypertrophy.

CONCLUSION: In our population of otherwise healthy Caucasian children, there was a high prevalence of hypertension that would not have been identified using standard office/clinic protocols.

Keywords: Blood pressure; Sleep apnea; Cardiovascular complications; Pediatrics