Ambulatory blood pressure monitoring in children and adolescents post-hematopoietic stem cell transplantation
Issued Date
2023-01-01
Resource Type
ISSN
0931041X
eISSN
1432198X
Scopus ID
2-s2.0-85170058858
Pubmed ID
37672081
Journal Title
Pediatric Nephrology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatric Nephrology (2023)
Suggested Citation
Homhuan W., Tosakulsak T., Pirojsakul K., Pakakasama S., Satawiriya M., Paksi W., Bunmee U. Ambulatory blood pressure monitoring in children and adolescents post-hematopoietic stem cell transplantation. Pediatric Nephrology (2023). doi:10.1007/s00467-023-06119-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/90029
Title
Ambulatory blood pressure monitoring in children and adolescents post-hematopoietic stem cell transplantation
Author's Affiliation
Other Contributor(s)
Abstract
Background: One of the long-term complications after hematopoietic stem cell transplantation (HSCT) is hypertension (HT). Previous studies showed that 10–15% of children post-HSCT had office HT, but only a few studies used ambulatory blood pressure monitoring (ABPM). The present study was aimed at exploring the frequency and factors associated with ABPM HT in children post-HSCT. Methods: Patients aged ≥ 6 years who survived ≥ 2 years after HSCT were enrolled. Clinical and ABPM data were reviewed. ABPM HT was defined according to the 2022 American Heart Association guidelines. Factors associated with HT were analyzed by logistic regression. Results: Ninety-eight (60 males) patients with a mean age of 15.1 years and a median follow-up time at 4.5 years after HSCT were included. Fifteen patients (15.3%) had ABPM HT (2 ambulatory HT and 13 masked HT). The ABPM HT group had a significantly older age (19 vs. 14 years), a higher proportion of males (87% vs. 57%), a higher office systolic BP index (0.93 vs. 0.85), a higher office diastolic BP index (0.96 vs. 0.82) and a higher proportion of current use of prednisolone and tacrolimus than those in the normal ABPM group. Multivariate analysis revealed that office diastolic BP index was associated with ABPM HT. Left ventricular mass index was significantly correlated with ABPM but not with office BP parameters. Conclusions: HT in children post-HSCT was not uncommon and most could not be detected with office BP measurement. A diastolic BP index can be used as a screening tool for HT. Graphical abstract: [Figure not available: see fulltext.]