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Table of Contents
Vol. 35, No. 2, 2012
Issue release date: March 2012
Free Access
Kidney Blood Press Res 2012;35:129–134
(DOI:10.1159/000331057)

Importance of Ambulatory Blood Pressure Monitoring in Adolescent Hypertension

Pall D.a · Kiss I.b · Katona E.a
aFirst Department of Medicine, University of Debrecen, Debrecen, and bDepartment of Nephrology-Hypertension, St. Imre Teaching Hospital, and 1st Dialysis Centre of B. Braun Avitum Hungary CPLC, Budapest, Hungary
email Corresponding Author

Abstract

There has been a steady increase in the prevalence of adolescent hypertension in recent years. In order to prevent target organ damages, it is important to determine the group of hypertensive adolescents. If repeatedly elevated blood pressure values are observed, with special emphasis on white coat hypertension, which is particularly frequent at this age, ambulatory blood pressure monitoring is highly recommended before pharmacological treatment is started. In addition, performing ambulatory blood pressure monitoring is recommended with target organ damage, resistance to therapy, and suspicion of secondary hypertension. The results of the widely available, simple-to-use device are easy to reproduce.


 goto top of outline Key Words

  • Adolescent hypertension
  • Ambulatory blood pressure monitoring

 goto top of outline Abstract

There has been a steady increase in the prevalence of adolescent hypertension in recent years. In order to prevent target organ damages, it is important to determine the group of hypertensive adolescents. If repeatedly elevated blood pressure values are observed, with special emphasis on white coat hypertension, which is particularly frequent at this age, ambulatory blood pressure monitoring is highly recommended before pharmacological treatment is started. In addition, performing ambulatory blood pressure monitoring is recommended with target organ damage, resistance to therapy, and suspicion of secondary hypertension. The results of the widely available, simple-to-use device are easy to reproduce.

Copyright © 2011 S. Karger AG, Basel


 goto top of outline References
  1. Hamet P, Pausova Z, Adarichev V, Adaricheva K, Tremblay J: Hypertension: genes and environment. J Hypertens 1998;16:397–418.
  2. Sorof JM, Lai D, Turner J Poffenbarger T, Portman RJ: Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004;113:475–482.
  3. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–576.
  4. Neutel JM: Beyond the sphygmomanometric numbers: hypertension as a syndrome. Am J Hypertens 2001;14:250S–257S.
  5. Sánchez-Bayle M, Muñoz-Fernández MT, González-Requejo A: A longitudinal study of blood pressure in Spanish schoolchildren. Working Group of Cardiovascular Risk Factors in Childhood and Adolescence. Arch Dis Child 1999;81:169–171.
  6. Li S, Chen W, Srinivasan SR, Berenson GS: Childhood blood pressure as a predictor of arterial stiffness in young adults: the Bogalusa Heart Study. Hypertension 2004;43:541–546.
  7. Páll D, Katona E, Fülesdi B, Zrínyi M, Zatik J, Bereczki D, et al: Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J Hypertens 2003;21:41–47.
  8. Graves JW, Althaf MM: Utility of ambulatory blood pressure monitoring in children and adolescents. Pediatr Nephrol 2006;21:1640–1652.
  9. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996;98:649–658.
  10. Reusz G, Hóbor M, Tulassay T, Sallay P, Miltényi M: 24-hour blood pressure monitoring in healthy and hypertensive children. Arch Dis Child 1994;70:90–94.
  11. Sorof JM, Portman RJ: Ambulatory blood pressure measurements. Curr Opin Pediatr 2001;13:133–137.
  12. Lurbe E, Sorof JM, Daniels SR: Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 2004;144:7–16.
  13. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al: 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the ESH and ESC. J Hypertens 2007;25:1105–1187.
  14. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, et al: European Society of Hypertension. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009;27:1719–1742.
  15. Zanchetti A, Mancia G, Black HR, Oparil S, Waeber B, Schmieder RE, et al: Facts and fallacies of blood pressure control in recent trials: implications in the management of patients with hypertension. J Hypertens 2009;27:673–679.
  16. O’Brien E, Atkins N, Staessen J: State of the market. A review of ambulatory blood pressure monitoring devices. Hypertension 1995;26:835–842.
  17. Portman RJ, Yetman RJ, West MS: Efficacy of 24-hour ambulatory blood pressure monitoring in children. J Pediatr 1991;118:842–849.
  18. Lurbe E, Redon J, Liao Y, Tacons J, Cooper RS, Alvarez V: Ambulatory blood pressure monitoring in normotensive children. J Hypertens 1994;12:1417–1423.
  19. Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, et al: Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1,141 subjects. J Pediatr 1997;130:178–184.
  20. Wühl E, Witte K, Soergel M, Mehls O, Schaefer F: German Working Group on Pediatric Hypertension. Distribution of 24-hour ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 2002;20:1995–2007.
  21. White WB, Schulman P, McCabe EJ, Dey HM: Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension. JAMA 1989;261:873–877.
  22. Sorof JM, Portman RJ: White coat hypertension in children with elevated casual blood pressure. J Pediatr 2000;137:493–497.
  23. Khan IA, Gajaria M, Stephens D, Balfe JW: Ambulatory blood pressure monitoring in children: a large center’s experience. Pediatr Nephrol 2000;14:802–905.
  24. Koshy S, Macarthur C, Luthra S, Gajaria M, Geary D: Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load. Pediatr Nephrol 2005;20:1484–1486.
  25. Kennedy SE, Mackie FE, Rosenberg AR, et al: Agreement on reporting of ambulatory blood pressure monitoring in children. Pediatr Nephrol 2005;20:1766–1768.
  26. Sorof JM, Cardwell G, Franco K, Portmann RJ: Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 2002;39:903–908.
  27. Mancia G, Parati G: The role of blood pressure variability in end-organ damage. J Hypertens Suppl 2003;21:S17–S23.
  28. Cuspidi C, Macca G, Sampieri L, Fusi V, Severgnini B, Michev I, et al: Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens 2001;19:1539–1545.
  29. Lurbe E, Redon J: Ambulatory blood pressure monitoring in children and adolescents: the future. J Hypertens 2000;18:1351–1354.
  30. Hornsby JL, Mongan PF, Taylor AT, Treiber FA: ‘White coat hypertension’ in children. J Fam Pract 1991;33:617–623.
  31. Stabouli S, Kotsis V, Toumandis S Papamichael C, Constantopoulos A, Zakopoulos N: White coat and masked hypertension in children: associated with target organ damage. Pediatr Nephrol 2005;20:1151–1155.
  32. Matsuoka S, Kawamura K, Honda M, Awazu M: White coat effect and white coat hypertension in pediatric patients. Pediatr Nephrol 2002;17:950–953.
  33. Parati G, Mancia G: Assessing the white coat effect: which blood pressure measurement should be considered? J Hypertens 2006;24:29–31.
  34. Morić VB, Delmis J, Sepec PM: Ambulatory blood pressure monitoring in children and adolescents – our results. Acta Med Croatica 2008;62(suppl 1):3–6.

    External Resources

  35. Floriańczyk T, Werner B: Usefulness of ambulatory blood pressure monitoring in diagnosis of arterial hypertension in children and adolescents. Kardiol Pol 2008;66:12–17.
  36. Sorof JM, Poffenbarger T, Franco K, Portman R: Evaluation of white coat hypertension in children: importance of definitions of normal ambulatory blood pressure and the severity of hypertension. Am J Hypertens 2001;14:855–860.
  37. Páll D, Juhász M, Lengyel S, Molnár C, Paragh G, Fülesdi B, et al: Assessment of target-organ damage in adolescent white-coat and sustained hypertensives. J Hypertens 2010;28:2139–2144.
  38. Pickering TG, Davidson K, Gerin W, Schwartz JE: Masked hypertension. Hypertension 2002;40:795–796.
  39. Lurbe E, Torro I, Alvarez V, Nawrot T, Paya R, Redon J, et al: Prevalence, persistence and clinical significance of masked hypertension in youth. Hypertension 2005;45:493–498.
  40. Clement DL, De Buyzere ML, De Bacquer DA, de Leeuw PW, Duprez DA, Fagard RH, et al: Office versus Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood pressure recordings in patients with treated hypertension. N Engl J Med 2003;348:2407–2415.
  41. Kiss I (ed): Guidelines for the treatment of high blood pressure in adulthood and childhood. Official Guideline of the Hungarian Society of Hypertension. Hypertens Nephrol 2009;13(suppl 2):81–168.
  42. Stergiou GS, Alamara CV, Salgami EV, Vaindirlis IN, Dacou-Voutetakis C, Mountokalakis TD: Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Pres Monit 2005;10:143–147.
  43. Mitsnefes MM, Kimball TR, Daniels SR: Office and ambulatory blood pressure elevation in children with chronic renal disease. Pediatr Nephrol 2003;18:145–149.
  44. Lande MB, Flynn JT: Treatment of hypertension in children and adolescents. Pediatr Nephrol 2009;24:1939–49.
  45. Morgan H, Khan I, Hashmi A, Hebert D, McCrindle BW, Balfe JW: Ambulatory blood pressure monitoring after renal transplantation in children. Pediatr Nephrol 2001;16:843–847.
  46. Lingens N, Dobos E, Witte K. Busch C, Lemmer B, Klaus G, et al: Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation. Pediatr Nephrol 1997;11:23–26.
  47. Giaconi S, Levanti C, Fommei E, Innocenti F, Seghieri G, Palla L, et al: Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. Am J Hypertens 1989;2:259–261.
  48. Török K, Pálfi A, Szelényi Z, Molnár D: Circadian variability of blood pressure in obese children. Nutr Metab Cardiovasc Dis 2008;18:429–435.
  49. Stabouli S, Kotsis V, Rizos Z, Toumanidis S, Karagianni C, Constantopoulos A, et al: Left ventricular mass in normotensive, prehypertensive and hypertensive children and adolescents. Pediatr Nephrol 2009;24:1545–1551.
  50. Flynn JT: Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics 2002;110:89–93.
  51. Alpay H, Ozdemir N, Wühl E, Topuzoğlu A: Ambulatory blood pressure monitoring in healthy children with parental hypertension. Pediatr Nephrol 2009;24:155–161.
  52. Malbora B, Baskin E, Bayrakci US, Agras PI, Cengiz N, Haberal M: Ambulatory blood pressure monitoring of healthy schoolchildren with a family history of hypertension. Ren Fail 2010;32:535–540.

 goto top of outline Author Contacts

Denes Pall, MD, PhD
First Department of Medicine
Medical and Health Science Center
University of Debrecen, HU–4032 Debrecen (Hungary)
Tel. +36 309 657 913, E-Mail pall.denes@gmail.com


 goto top of outline Article Information

Published online: November 1, 2011
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 52


 goto top of outline Publication Details

Kidney and Blood Pressure Research

Vol. 35, No. 2, Year 2012 (Cover Date: March 2012)

Journal Editor: Tesar V. (Prague)
ISSN: 1420-4096 (Print), eISSN: 1423-0143 (Online)

For additional information: http://www.karger.com/KBR


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

There has been a steady increase in the prevalence of adolescent hypertension in recent years. In order to prevent target organ damages, it is important to determine the group of hypertensive adolescents. If repeatedly elevated blood pressure values are observed, with special emphasis on white coat hypertension, which is particularly frequent at this age, ambulatory blood pressure monitoring is highly recommended before pharmacological treatment is started. In addition, performing ambulatory blood pressure monitoring is recommended with target organ damage, resistance to therapy, and suspicion of secondary hypertension. The results of the widely available, simple-to-use device are easy to reproduce.



 goto top of outline Author Contacts

Denes Pall, MD, PhD
First Department of Medicine
Medical and Health Science Center
University of Debrecen, HU–4032 Debrecen (Hungary)
Tel. +36 309 657 913, E-Mail pall.denes@gmail.com


 goto top of outline Article Information

Published online: November 1, 2011
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 52


 goto top of outline Publication Details

Kidney and Blood Pressure Research

Vol. 35, No. 2, Year 2012 (Cover Date: March 2012)

Journal Editor: Tesar V. (Prague)
ISSN: 1420-4096 (Print), eISSN: 1423-0143 (Online)

For additional information: http://www.karger.com/KBR


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Hamet P, Pausova Z, Adarichev V, Adaricheva K, Tremblay J: Hypertension: genes and environment. J Hypertens 1998;16:397–418.
  2. Sorof JM, Lai D, Turner J Poffenbarger T, Portman RJ: Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004;113:475–482.
  3. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–576.
  4. Neutel JM: Beyond the sphygmomanometric numbers: hypertension as a syndrome. Am J Hypertens 2001;14:250S–257S.
  5. Sánchez-Bayle M, Muñoz-Fernández MT, González-Requejo A: A longitudinal study of blood pressure in Spanish schoolchildren. Working Group of Cardiovascular Risk Factors in Childhood and Adolescence. Arch Dis Child 1999;81:169–171.
  6. Li S, Chen W, Srinivasan SR, Berenson GS: Childhood blood pressure as a predictor of arterial stiffness in young adults: the Bogalusa Heart Study. Hypertension 2004;43:541–546.
  7. Páll D, Katona E, Fülesdi B, Zrínyi M, Zatik J, Bereczki D, et al: Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J Hypertens 2003;21:41–47.
  8. Graves JW, Althaf MM: Utility of ambulatory blood pressure monitoring in children and adolescents. Pediatr Nephrol 2006;21:1640–1652.
  9. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996;98:649–658.
  10. Reusz G, Hóbor M, Tulassay T, Sallay P, Miltényi M: 24-hour blood pressure monitoring in healthy and hypertensive children. Arch Dis Child 1994;70:90–94.
  11. Sorof JM, Portman RJ: Ambulatory blood pressure measurements. Curr Opin Pediatr 2001;13:133–137.
  12. Lurbe E, Sorof JM, Daniels SR: Clinical and research aspects of ambulatory blood pressure monitoring in children. J Pediatr 2004;144:7–16.
  13. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al: 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the ESH and ESC. J Hypertens 2007;25:1105–1187.
  14. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, et al: European Society of Hypertension. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009;27:1719–1742.
  15. Zanchetti A, Mancia G, Black HR, Oparil S, Waeber B, Schmieder RE, et al: Facts and fallacies of blood pressure control in recent trials: implications in the management of patients with hypertension. J Hypertens 2009;27:673–679.
  16. O’Brien E, Atkins N, Staessen J: State of the market. A review of ambulatory blood pressure monitoring devices. Hypertension 1995;26:835–842.
  17. Portman RJ, Yetman RJ, West MS: Efficacy of 24-hour ambulatory blood pressure monitoring in children. J Pediatr 1991;118:842–849.
  18. Lurbe E, Redon J, Liao Y, Tacons J, Cooper RS, Alvarez V: Ambulatory blood pressure monitoring in normotensive children. J Hypertens 1994;12:1417–1423.
  19. Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, et al: Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1,141 subjects. J Pediatr 1997;130:178–184.
  20. Wühl E, Witte K, Soergel M, Mehls O, Schaefer F: German Working Group on Pediatric Hypertension. Distribution of 24-hour ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 2002;20:1995–2007.
  21. White WB, Schulman P, McCabe EJ, Dey HM: Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension. JAMA 1989;261:873–877.
  22. Sorof JM, Portman RJ: White coat hypertension in children with elevated casual blood pressure. J Pediatr 2000;137:493–497.
  23. Khan IA, Gajaria M, Stephens D, Balfe JW: Ambulatory blood pressure monitoring in children: a large center’s experience. Pediatr Nephrol 2000;14:802–905.
  24. Koshy S, Macarthur C, Luthra S, Gajaria M, Geary D: Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load. Pediatr Nephrol 2005;20:1484–1486.
  25. Kennedy SE, Mackie FE, Rosenberg AR, et al: Agreement on reporting of ambulatory blood pressure monitoring in children. Pediatr Nephrol 2005;20:1766–1768.
  26. Sorof JM, Cardwell G, Franco K, Portmann RJ: Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 2002;39:903–908.
  27. Mancia G, Parati G: The role of blood pressure variability in end-organ damage. J Hypertens Suppl 2003;21:S17–S23.
  28. Cuspidi C, Macca G, Sampieri L, Fusi V, Severgnini B, Michev I, et al: Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients. J Hypertens 2001;19:1539–1545.
  29. Lurbe E, Redon J: Ambulatory blood pressure monitoring in children and adolescents: the future. J Hypertens 2000;18:1351–1354.
  30. Hornsby JL, Mongan PF, Taylor AT, Treiber FA: ‘White coat hypertension’ in children. J Fam Pract 1991;33:617–623.
  31. Stabouli S, Kotsis V, Toumandis S Papamichael C, Constantopoulos A, Zakopoulos N: White coat and masked hypertension in children: associated with target organ damage. Pediatr Nephrol 2005;20:1151–1155.
  32. Matsuoka S, Kawamura K, Honda M, Awazu M: White coat effect and white coat hypertension in pediatric patients. Pediatr Nephrol 2002;17:950–953.
  33. Parati G, Mancia G: Assessing the white coat effect: which blood pressure measurement should be considered? J Hypertens 2006;24:29–31.
  34. Morić VB, Delmis J, Sepec PM: Ambulatory blood pressure monitoring in children and adolescents – our results. Acta Med Croatica 2008;62(suppl 1):3–6.

    External Resources

  35. Floriańczyk T, Werner B: Usefulness of ambulatory blood pressure monitoring in diagnosis of arterial hypertension in children and adolescents. Kardiol Pol 2008;66:12–17.
  36. Sorof JM, Poffenbarger T, Franco K, Portman R: Evaluation of white coat hypertension in children: importance of definitions of normal ambulatory blood pressure and the severity of hypertension. Am J Hypertens 2001;14:855–860.
  37. Páll D, Juhász M, Lengyel S, Molnár C, Paragh G, Fülesdi B, et al: Assessment of target-organ damage in adolescent white-coat and sustained hypertensives. J Hypertens 2010;28:2139–2144.
  38. Pickering TG, Davidson K, Gerin W, Schwartz JE: Masked hypertension. Hypertension 2002;40:795–796.
  39. Lurbe E, Torro I, Alvarez V, Nawrot T, Paya R, Redon J, et al: Prevalence, persistence and clinical significance of masked hypertension in youth. Hypertension 2005;45:493–498.
  40. Clement DL, De Buyzere ML, De Bacquer DA, de Leeuw PW, Duprez DA, Fagard RH, et al: Office versus Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood pressure recordings in patients with treated hypertension. N Engl J Med 2003;348:2407–2415.
  41. Kiss I (ed): Guidelines for the treatment of high blood pressure in adulthood and childhood. Official Guideline of the Hungarian Society of Hypertension. Hypertens Nephrol 2009;13(suppl 2):81–168.
  42. Stergiou GS, Alamara CV, Salgami EV, Vaindirlis IN, Dacou-Voutetakis C, Mountokalakis TD: Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Pres Monit 2005;10:143–147.
  43. Mitsnefes MM, Kimball TR, Daniels SR: Office and ambulatory blood pressure elevation in children with chronic renal disease. Pediatr Nephrol 2003;18:145–149.
  44. Lande MB, Flynn JT: Treatment of hypertension in children and adolescents. Pediatr Nephrol 2009;24:1939–49.
  45. Morgan H, Khan I, Hashmi A, Hebert D, McCrindle BW, Balfe JW: Ambulatory blood pressure monitoring after renal transplantation in children. Pediatr Nephrol 2001;16:843–847.
  46. Lingens N, Dobos E, Witte K. Busch C, Lemmer B, Klaus G, et al: Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation. Pediatr Nephrol 1997;11:23–26.
  47. Giaconi S, Levanti C, Fommei E, Innocenti F, Seghieri G, Palla L, et al: Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. Am J Hypertens 1989;2:259–261.
  48. Török K, Pálfi A, Szelényi Z, Molnár D: Circadian variability of blood pressure in obese children. Nutr Metab Cardiovasc Dis 2008;18:429–435.
  49. Stabouli S, Kotsis V, Rizos Z, Toumanidis S, Karagianni C, Constantopoulos A, et al: Left ventricular mass in normotensive, prehypertensive and hypertensive children and adolescents. Pediatr Nephrol 2009;24:1545–1551.
  50. Flynn JT: Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics 2002;110:89–93.
  51. Alpay H, Ozdemir N, Wühl E, Topuzoğlu A: Ambulatory blood pressure monitoring in healthy children with parental hypertension. Pediatr Nephrol 2009;24:155–161.
  52. Malbora B, Baskin E, Bayrakci US, Agras PI, Cengiz N, Haberal M: Ambulatory blood pressure monitoring of healthy schoolchildren with a family history of hypertension. Ren Fail 2010;32:535–540.