24-hour blood pressure assessments provide little value

When evaluating a pediatric patient for hypertension, healthcare providers often monitor the child’s blood pressure for a 24-hour period. However, according to new findings published in the Clinical Journal of the American Society of Nephrology, such “blood pressure load” assessments may not provide significant value.  

Worried that these 24-hour measurements could create confusion among physicians, the study’s authors explored data from more than 500 pediatric patients with chronic kidney disease. The team monitored each participant’s blood pressure for 24 hours, performing a variety of tests related to kidney and heart health over the course of several years.

Patients were separated into three groups: “normal blood pressure,” “high blood pressure load without high average blood pressure,” and “high average blood pressure.” Overall, the researchers found, one in four children had a high blood pressure load—but such a finding was not associated with higher risks of kidney failure or left ventricular hypertrophy.

“Our data suggest that the proportion of readings on a 24-hour blood pressure test that are high may not provide additional insight beyond the average blood pressure values surrounding a child's risk for developing cardiac disease or worsening kidney disease,” lead author Jason Lee, MD, University of California San Francisco, said in a prepared statement. “However, having a high average blood pressure on a 24-hour blood pressure test does strongly predict a child's cardiac and kidney disease risk.”