Objective: To defining the criteria for performing ambulatory blood pressure monitoring (ABPM) in young patients.
Method: It is reported the experience with ABPM on 52 consecutive patients (younger than 30 years old) consulting for hypertension (mean age 23.4 +/- 4.9 years). The ambulatory BP was measured noninvasively for twenty-seven hours by the Spacelabs 90207 device programmed to measure BP every fifteen minutes during daytime and every 20 minutes during nighttime. The definition of daytime and nighttime was made on the basis of wakefulness and sleep or bed rest periods, obtained from a diary kept by the subject, normal nocturnal BP drop was defined as a decrease higher of 10% versus daytime values. It was defined normal BP an 24 hours ambulatory BP < 130/80 mmHg.
Results: Thirty seven patients (71%) were normotensives. There were not differences between normotensive and hypertensive patients neither by age (normotensive 23.9 +/- 12.5, hypertensive 23.3 +/- 4.0 years), nor by sex (normotensive, 21 men and 16 women; hypertensive, 10 men and 3 women). Mean 24 h BP of normotensive patients was 119/72 mmHg (p < 0.001 vs. hypertensive, 135/89 mmHg). There were not differences in nocturnal BP drop. White-coat reaction was more intense in normotensive patients (1.17 +/- 0.12, vs. hypertensive 1.04 +/- 0.08, p < 0.001). Four hypertensives showed white-coat reaction (1.11 +/- 0.05).
Conclusion: ABPM is a helpful diagnostic tool in young patients. It should be routinely performed as first exploration in all patients younger than 30 years consulting for hypertension.