Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

Children with sleep disordered breathing (SDB) show increases in several ambulatory blood pressure parameters, as well as left ventricular wall thickening, according to a report in the January issue of Hypertension. Children with sleep disordered breathing (SDB) show increases in several ambulatory blood pressure parameters, as well as left ventricular wall thickening, according to a report in the January issue of Hypertension.

"A mild degree of SDB is associated with morning blood pressure surge, an important determinant of cardiac remodeling," Dr. Raouf Amin from Cincinnati Children's Hospital Medical Center, Ohio told Reuters Health. "Subgroup analysis on lean subjects clearly indicates that the observed changes are independent of body-mass index (BMI)."

Dr. Amin and associates measured activity-adjusted morning blood pressure surge, blood pressure load, and diurnal and nocturnal blood pressure in 140 children with or without SDB, using ambulatory monitoring.

Morning blood pressure surge was significantly higher in children with mild SDB (apnea-hypopnea index (AHI) below 5) and in children with severe SDB (AHI 5 or higher) than in children without SDB (controls), the authors report.

Children with severe SDB also had significantly higher systolic, diastolic, and mean arterial blood pressures and significantly higher mean morning heart rates than did the controls.

Relative ventricular wall thickness and left ventricular mass index were significantly higher in children with severe SDB than in healthy control children, the researchers note, and blood pressure parameters were significant predictors of both measures.

BMI and SDB severity had similar effects on blood pressure parameters, except that SDB had a significantly greater effect than BMI on nocturnal diastolic blood pressure.

"The clinical significance of the differences in blood pressure parameters between children with SDB and healthy controls is highlighted by the observed independent association between blood pressure and left ventricular remodeling," the investigators say.

"We have ongoing studies to determine the effect of treatment on blood pressure and cardiac remodeling," Dr. Amin said. "A manuscript in press will describe the effect of recurrence of SDB after adenotonsillectomy on blood pressure."

Dr. Amin added, "Ambulatory BP monitoring and echocardiography will become important outcomes when we describe in future manuscripts how blood pressure relates to SDB control.