Purpose of Review
This article highlights the importance of ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension (HTN) in children and appropriate technique for performing ABPM, following a recent scientific statement from the American Heart Association (AHA) in 2022. We will also discuss the association of ABPM results with target organ damage (TOD).
Recent Findings
There is growing evidence to suggest that HTN in youth is associated with TOD and increased risk of cardiovascular disease in adulthood. Our current management of youth HTN and studies of its consequences are based on the recent AHA pediatric ABPM guidelines, which provided streamlined BP categories aligned with adults and European guidelines. The update increased the diagnosis of HTN in children and appears to have improved the prediction of TOD compared to the 2014 pediatric ABPM guidelines.
Summary
The management of pediatric HTN includes accurate diagnosis and early intervention to prevent TOD. While office BP can be used as a screening technique, ABPM should be used to confirm the diagnosis of HTN in all pediatric patients using the 2022 AHA pediatric ABPM guidelines. However, there are some limitations associated with performing ABPM in children, including a lack of ambulatory BP criteria for diverse pediatric populations and for young children.
