A serdülőkori hypertonia prevalenciája növekszik. A hazai epidemiológiai vizsgálat 2,5%-os, míg a legújabb nemzetközi eredmény 4,5%-os gyakoriságot jelez. A jelenleg elérhető európai ajánlás a diagnózis felállításához ismételt eseti méréseket tart szükségesnek, nem követeli meg az ambuláns vérnyomás-monitorozás elvégzését. Az elmúlt években a serdülőkori ambuláns vérnyomás-monitorozással kapcsolatosan számos adat látott napvilágot. Bizonyított, hogy eredményei jobban korrelálnak a célszervkárosodásokkal, mint az eseti mérések. Az ismételt mérések alapján hypertoniásnak minősített fiatalok 21–47%-ánál a 24 órás monitorozás normotoniát bizonyított, vagyis fehérköpeny-hypertonia igazolható. Szintén e módszerrel lehetséges a maszkírozott hypertonia felismerése, amelynek gyakorisága 7–11%-ra tehető. Szekunder hypertonia gyanúja esetén is hasznos adatokat nyerhetünk. Az új európai konszenzus megjelenéséig is célszerű serdülőkorban szélesebb körben élni az ambuláns vérnyomás-monitorozás nyújtotta lehetőségekkel, fontos az eseti mérések alapján felállított diagnózis megerősítése. Fehérköpeny-, illetve maszkírozott hypertonia gyanúja, célszervkárosodás igazolódása, valamint terápiarezisztens hypertonia esetén is feltétlen ajánlott az elvégzése. Serdülőkorban vérnyomáscsökkentő gyógyszeres kezelés indítása előtt a szerzők mindenképpen szükségesnek tartják az ambuláns vérnyomás-monitorozás elvégzését.
Hajjar, I., Kotchen, T. A.: Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA, 2003, 290 , 199–206.
Kotchen T. A. , 'Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000 ' (2003 ) 290 JAMA : 199 -206.
Hamet, P., Pausova, Z., Adarichev, V. és mtsai: Hypertension: genes and environment. J. Hypertens., 1998, 16 , 397–418.
Adarichev V. , 'Hypertension: genes and environment ' (1998 ) 16 J. Hypertens. : 397 -418.
Sorof, J. M., Lai, D., Turner, J. és mtsai: Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics, 2004, 113 , 475–482.
Turner J. , 'Overweight, ethnicity, and the prevalence of hypertension in school-aged children ' (2004 ) 113 Pediatrics : 475 -482.
Páll D., Katona E., Paragh Gy. és mtsai: A 15–18 éves fiatalok epidemiológiai jellemzői, és a serdülőkori hypertonia prevalenciája. Orv. Hetil., 2005, 146 , 127–132.
Paragh Gy. , 'A 15–18 éves fiatalok epidemiológiai jellemzői, és a serdülőkori hypertonia prevalenciája ' (2005 ) 146 Orv. Hetil. : 127 -132.
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.
'The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents ' (2004 ) 114 Pediatrics : 555 -576.
Neutel, J. M.: Beyond the sphygmomanometric numbers: hypertension as a syndrome. Am. J. Hypertens., 2001, 14 , 250S–257S.
Neutel J. M. , 'Beyond the sphygmomanometric numbers: hypertension as a syndrome ' (2001 ) 14 Am. J. Hypertens. : 250S -257S.
Sánchez-Bayle, M., Muñoz-Fernández, M. T., 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.
González-Requejo A. , 'A longitudinal study of blood pressure in Spanish schoolchildren. Working Group of Cardiovascular Risk Factors in Childhood and Adolescence ' (1999 ) 81 Arch. Dis. Child. : 169 -171.
Li, S., Chen, W., Srinivasan, S. R. és mtsa: Childhood blood pressure as a predictor of arterial stiffness in young adults: the Bogalusa Heart Study. Hypertension, 2004, 43 , 541–546.
Srinivasan S. R. , 'Childhood blood pressure as a predictor of arterial stiffness in young adults: the Bogalusa Heart Study ' (2004 ) 43 Hypertension : 541 -546.
Lewington, S., Clarke, R., Qizilbash, N. és mtsai: Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 2002, 360 , 1903–1913.
Qizilbash N. , 'Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies ' (2002 ) 360 Lancet : 1903 -1913.
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.
'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 ' (1996 ) 98 Pediatrics : 649 -658.
Páll, D., Katona, É., Fülesdi, B. és mtsai: Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J. Hypertens., 2003, 21 , 41–47.
Fülesdi B. , 'Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA ' (2003 ) 21 J. Hypertens. : 41 -47.
Magyar Hypertonia Társaság (szerk.: Kiss I. ): A hipertónia betegség felnőttkori és gyermekkori kezelésének szakmai és szervezeti irányelvei. Kardiológiai Útmutató, 2008, 108–205.
'A hipertónia betegség felnőttkori és gyermekkori kezelésének szakmai és szervezeti irányelvei ' (2008 ) Kardiológiai Útmutató : 108 -205.
Reusz, G. S., Hóbor, M., Tulassay, T. és mtsai: 24 hour blood pressure monitoring in healthy and hypertensive children. Arch. Dis. Child, 1994, 70 , 90–94.
Tulassay T. , '24 hour blood pressure monitoring in healthy and hypertensive children ' (1994 ) 70 Arch. Dis. Child : 90 -94.
Sorof, J. M., Portman, R. J.: Ambulatory blood pressure measurements. Curr. Opin. Pediatr., 2001, 13 , 133–137.
Portman R. J. , 'Ambulatory blood pressure measurements ' (2001 ) 13 Curr. Opin. Pediatr. : 133 -137.
Lurbe, E., Sorof, J. M., Daniels, S. R.: Clinical and research aspects of ambulatory blood pressure monitoring in children. J. Pediatr., 2004, 144 , 7–16.
Daniels S. R. , 'Clinical and research aspects of ambulatory blood pressure monitoring in children ' (2004 ) 144 J. Pediatr. : 7 -16.
Mancia, G., De Backer, G., Dominiczak, A. és mtsai: 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.
Dominiczak A. , '2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the ESH and ESC ' (2007 ) 25 J. Hypertens. : 1105 -1187.
O’Brien, E., Atkins, N., Staessen, J.: State of the market. A review of ambulatory blood pressure monitoring devices. Hypertension, 1995, 26 , 835–842.
Staessen J. , 'State of the market. A review of ambulatory blood pressure monitoring devices ' (1995 ) 26 Hypertension : 835 -842.
Portman, R. J., Yetman, R. J., West, M. S.: Efficacy of 24-hour ambulatory blood pressure monitoring in children. J. Pediatr., 1991, 118 , 842–849.
West M. S. , 'Efficacy of 24-hour ambulatory blood pressure monitoring in children ' (1991 ) 118 J. Pediatr. : 842 -849.
Lurbe, E., Redon, J., Liao, Y. és mtsai: Ambulatory blood pressure monitoring in normotensive children. J. Hypertens., 1994, 12 , 1417–1423.
Liao Y. , 'Ambulatory blood pressure monitoring in normotensive children ' (1994 ) 12 J. Hypertens. : 1417 -1423.
Soergel, M., Kirschstein, M., Busch, C. és mtsai: Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J. Pediatr., 1997, 130 , 178–184.
Busch C. , 'Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects ' (1997 ) 130 J. Pediatr. : 178 -184.
Wasilewski, A., Zoch-Zwierz, W., Tomaszenka, B. és mtsa: Reference values of 24 hour ambulatory blood pressure in healthy children in Poland. Pol. Merkuriusz Lek, 2004, 17 , 451–456.
Tomaszenka B. , 'Reference values of 24 hour ambulatory blood pressure in healthy children in Poland ' (2004 ) 17 Pol. Merkuriusz Lek : 451 -456.
Wühl, E., Witte, K., Soergel, M. és mtsai: German Working Group on Pediatric Hypertension. Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J. Hypertens., 2002, 20 , 1995–2007.
Soergel M. , 'German Working Group on Pediatric Hypertension. Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions ' (2002 ) 20 J. Hypertens. : 1995 -2007.
White, W. B., Schulman, P., McCabe, E. J. és mtsa: Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension. JAMA, 1989, 261 , 873–877.
McCabe E. J. , 'Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension ' (1989 ) 261 JAMA : 873 -877.
Sorof, J. M., Portman, R. J.: White coat hypertension in children with elevated casual blood pressure. J. Pediatr., 2000, 137 , 493–497.
Portman R. J. , 'White coat hypertension in children with elevated casual blood pressure ' (2000 ) 137 J. Pediatr. : 493 -497.
Khan, I. A., Gajaria, M., Stephens, D. és mtsa: Ambulatory blood pressure monitoring in children: a large center’s experience. Pediatr. Nephrol., 2000, 14 , 802–805.
Stephens D. , 'Ambulatory blood pressure monitoring in children: a large center’s experience ' (2000 ) 14 Pediatr. Nephrol. : 802 -805.
Koshy, S., Macarthur, C., Luthra, S. és mtsai: Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load. Pediatr. Nephrol., 2005, 20 , 1484–1486.
Luthra S. , 'Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load ' (2005 ) 20 Pediatr. Nephrol. : 1484 -1486.
Kennedy, S. E., Mackie, F. E., Rosenberg, A. R. és mtsai: Agreement on reporting of ambulatory blood pressure monitoring in children. Pediatr. Nephrol., 2005, 20 , 1766–1768.
Rosenberg A. R. , 'Agreement on reporting of ambulatory blood pressure monitoring in children ' (2005 ) 20 Pediatr. Nephrol. : 1766 -1768.
Sorof, J. M., Cardwell, G., Franco, K. és mtsa: Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension, 2002, 39 , 903–908.
Franco K. , 'Ambulatory blood pressure and left ventricular mass index in hypertensive children ' (2002 ) 39 Hypertension : 903 -908.
Mancia, G., Parati, G.: The role of blood pressure variability in end-organ damage. J. Hypertens. Suppl., 2003, 21 , S17–23.
Parati G. , 'The role of blood pressure variability in end-organ damage ' (2003 ) 21 J. Hypertens. Suppl. : S17 -23.
Cuspidi, C., Macca, G., Sampieri, L. és mtsai: 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.
Sampieri L. , 'Target organ damage and non-dipping pattern defined by two sessions of ambulatory blood pressure monitoring in recently diagnosed essential hypertensive patients ' (2001 ) 19 J. Hypertens. : 1539 -1545.
Lurbe, E., Redon, J.: Ambulatory blood pressure monitoring in children and adolescents: the future. J. Hypertens., 2000, 18 , 1351–1354.
Redon J. , 'Ambulatory blood pressure monitoring in children and adolescents: the future ' (2000 ) 18 J. Hypertens. : 1351 -1354.
Hornsby, J. L., Mongan, P. F., Taylor, T. és mtsa: “White coat hypertension” in children. J. Fam. Pract., 1991, 33 , 617–623.
Taylor T. , '“White coat hypertension” in children ' (1991 ) 33 J. Fam. Pract. : 617 -623.
Stabouli, S., Kotsis, V., Toumandis, S. és mtsai: White coat and masked hypertension in children: associated with target organ damage. Pediatr. Nephrol., 2005, 20 , 1151–1155.
Toumandis S. , 'White coat and masked hypertension in children: associated with target organ damage ' (2005 ) 20 Pediatr. Nephrol. : 1151 -1155.
Matsuoka, S., Kawamura, K., Honda, M. és mtsa: White coat effect and white coat hypertension in pediatric patients. Pediatr. Nephrol., 2002, 17 , 950–953.
Honda M. , 'White coat effect and white coat hypertension in pediatric patients ' (2002 ) 17 Pediatr. Nephrol. : 950 -953.
Parati, G., Mancia, G.: Assessing the white coat effect: which blood pressure measurement should be considered? J. Hypertens., 2006, 24 , 29–31.
Mancia G. , 'Assessing the white coat effect: which blood pressure measurement should be considered? ' (2006 ) 24 J. Hypertens. : 29 -31.
Morić, V. B., Delmis, J., Sepec, P. M.: Ambulatory blood pressure monitoring in children and adolescents – our results. Acta Med. Croatica, 2008, 62 , 3–6.
Sepec P. M. , 'Ambulatory blood pressure monitoring in children and adolescents – our results ' (2008 ) 62 Acta Med. Croatica : 3 -6.
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.
Werner B. , 'Usefulness of ambulatory blood pressure monitoring in diagnosis of arterial hypertension in children and adolescents ' (2008 ) 66 Kardiol. Pol. : 12 -17.
Sorof, J. M., Poffenbarger, T., Franco, K. és mtsa: 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.
Franco K. , 'Evaluation of white coat hypertension in children: importance of definitions of normal ambulatory blood pressure and the severity of hypertension ' (2001 ) 14 Am. J. Hypertens. : 855 -860.
Pickering, T. G., Davidson, K., Gerin, W. és mtsa: Masked hypertension. Hypertension, 2002, 40 , 795–796.
Gerin W. , 'Masked hypertension ' (2002 ) 40 Hypertension : 795 -796.
Lurbe, E., Torro, I., Alvarez, V. és mtsai: Prevalence, persistence and clinical significance of masked hypertension in youth. Hypertension, 2005, 45 , 493–498.
Alvarez V. , 'Prevalence, persistence and clinical significance of masked hypertension in youth ' (2005 ) 45 Hypertension : 493 -498.
Clement, D. L., De Buyzere, M. L., De Bacquer, D. A. és mtsai: 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.
Bacquer D. A. , 'Office versus Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood pressure recordings in patients with treated hypertension ' (2003 ) 348 N. Engl. J. Med. : 2407 -2415.
Stergiou, G. S., Alamara, C. V., Salgami, E. V. és mtsai: Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Pres Monit., 2005, 10 , 143–147.
Salgami E. V. , 'Reproducibility of home and ambulatory blood pressure in children and adolescents ' (2005 ) 10 Blood Pres Monit. : 143 -147.
Mitsnefes, M. M., Kimball, T. R., Daniels, S. R.: Office and ambulatory blood pressure elevation in children with chronic renal disease. Pediatr. Nephrol., 2003, 18 , 145–149.
Daniels S. R. , 'Office and ambulatory blood pressure elevation in children with chronic renal disease ' (2003 ) 18 Pediatr. Nephrol. : 145 -149.
Lande, M. B., Flynn, J. T.: Treatment of hypertension in children and adolescents. Pediatr. Nephrol., 2009, 24 , 1939–1949. [Published online: 10August 2007]
Flynn J. T. , 'Treatment of hypertension in children and adolescents ' (2009 ) 24 Pediatr. Nephrol. : 1939 -1949.
Morgan, H., Khan, I., Hashmi, A. és mtsai: Ambulatory blood pressure monitoring after renal transplantation in children. Pediatr. Nephrol., 2001, 16 , 843–847.
Hashmi A. , 'Ambulatory blood pressure monitoring after renal transplantation in children ' (2001 ) 16 Pediatr. Nephrol. : 843 -847.
Lingens, N., Dobos, E., Witte, K. és mtsai: Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation. Pediatr. Nephrol., 1997, 11 , 23–26.
Witte K. , 'Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation ' (1997 ) 11 Pediatr. Nephrol. : 23 -26.
Giaconi, S., Levanti, C., Fommei, E. és mtsai: 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.
Fommei E. , 'Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension ' (1989 ) 2 Am. J. Hypertens. : 259 -261.
Török K., Pálfi A., Szelényi Z. és mtsa: Circadian variability of blood pressure in obese children. Nutr. Metab. Cardiovasc. Dis., 2008, 18 , 429–435.
Szelényi Z. , 'Circadian variability of blood pressure in obese children ' (2008 ) 18 Nutr. Metab. Cardiovasc. Dis. : 429 -435.
Flynn, J. T.: Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Pediatrics, 2002, 110 , 89–93.
Flynn J. T. , 'Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring ' (2002 ) 110 Pediatrics : 89 -93.
Alpay, H., Ozdemir, N., Wühl, E. és mtsa: Ambulatory blood pressure monitoring in healthy children with parental hypertension. Pediatr. Nephrol., 2009, 24 , 155–161.
Wühl E. , 'Ambulatory blood pressure monitoring in healthy children with parental hypertension ' (2009 ) 24 Pediatr. Nephrol. : 155 -161.