Çakıcı et al. J Hypertens Manag 2019, 5:043 Volume 5 | Issue 2 DOI: 10.23937/2474-3690/1510043 Open Access ISSN: 2474-3690 Journal of Hypertension and Management Citaton: Çakıcı EK, Şükür EDK, Yazılıtaş F, Gür G, Güngör T, et al. (2019) White Coat Hypertension in Children and Adolescents: Innocent or Not?. J Hypertens Manag 5:043. doi.org/10.23937/2474- 3690/1510043 Accepted: September 28, 2019: Published: September 30, 2019 Copyright: © 2019 Çakıcı EK, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. • Page 1 of 6 • Çakıcı et al. J Hypertens Manag 2019, 5:043 White Coat Hypertension in Children and Adolescents: Innocent or Not? Evrim Kargın Çakıcı * , Eda Didem Kurt Şükür, Fatma Yazılıtaş, Gökçe Gür, Tülin Güngör, Evra Çelikkaya, Deniz Karakaya and Mehmet Bülbül Abstract Background: The clinical signifcance of white coat hyper- tension is still uncertain. We aimed to evaluate children with white coat hypertension regarding their clinical, laboratory characteristics, evidence of target organ damage and com- pare them to normotensive and hypertensive children. Methods: Fourty patients diagnosed with white coat hy- pertension, 40 patients with primary hypertension and 40 normotensive children of similar age, gender and body mass index were included in the study. Ambulatory blood pressure monitoring and echocardiographic examination were performed to all children. Clinical and laboratory characteristics were noted. Results: All ambulatory blood pressure monitoring pa- rameters, except night-time diastolic blood pressures and loads, were signifcantly higher in patients with white coat hypertension compared to normotensive ones. Left ven- tricular hypertrophy was 35% in the primary, 15% in the white coat hypertension group, and no left ventricular hy- pertrophy was detected in normotensive patients. No sig- nifcant difference was found between 3 groups in terms of proteinuria or retinopathy. Conclusions: Children diagnosed with white coat hyper- tension had ambulatory blood pressure monitoring mea- surements and left ventricular mass index values smaller than patients with primary hypertension but more than nor- motensive children. Echocardiographic changes might sug- gest that white coat hypertension can be associated with target-organ damage. Keywords Blood pressure, Hypertension, White coat hypertension, Left ventricular hypertrophy REsEaRch aRTiclE *Corresponding author: Evrim Kargin Cakici, MD, Department of Pediatric Nephrology and Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey, GSM: 00905052653472 Department of Pediatric Nephrology and Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey Introducton After the advent of ambulatory blood pressure monitoring (ABPM) the management of blood pres- sure (BP) has dramatically changed [1,2]. Ambulatory blood pressure monitoring provides a more accurate measurement of BP than auscultatory or automated office readings and it is shown to be superior in ad- ministration or adjustion of antihypertensive treat- ment and prediction of cardiovascular morbidity. An- other superiority of ABPM is the detection of white coat hypertension (WCH) and avoiding unnecessary further testing in these patients. As highlighted by the recent American Academy of Pediatrics Clinical Practice Guideline for Screening and Management of Elevated Blood Pressure in Children and Adolescents, the majority of the pediatric population has primary HT. However, emphasis was placed on evaluation for WCH by ABPM before diagnosing HT [2]. White coat HT is defned as elevated ofce BP mea- surements with normal BPs outside of the ofce set- tng. Ambulatory BP monitoring is ofen utlized for es- tablishing the diagnosis. Various studies have reported a wide range in WCH prevalence ranging from 12.9% to 88% of children depending on the criteria used [3- 5]. Clinical signifcance of WCH in children is a mater of debate. Since several earlier studies did not show signifcant target organ damage associated with WCH and it has been believed that WCH is a rather benign conditon in children which does not require therapeu- Check for updates