Title: Incidence of white coat hypertension and mask hypertension with varying body mass index in children

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Abstract

This study examined the incidence of white-coat hypertension (WCH) and masked hypertension (MHT) in the pediatric population with varying body mass index at our tertiary specialty clinic. We analyzed 174 patients that were referred to our center for the evaluation of hypertension. All of these patients were evaluated with 24-hour ambulatory blood pressure monitor (ABPM). We also obtained their body mass index (BMI), family history, gender, age, and ethnicity. The study showed that patients with a high BMI have a higher incidence of white coat hypertension. Of The patients with a BMI of greater than 30, 69% had WCH, of patients with a BMI from 25 to 30, 59% had WCH and of patients with a BMI of less than 25, 41% had WCH.  In contrast, masked hypertension was observed more frequently in lean patients; 20% of patients with MHT had a BMI of less than 25, 17% of patients with MHT had a BMI of 25 to 30 and 5% of patients with MHT had a BMI of more than 30.

In conclusion, ABPM is an effective tool to evaluate the white coat hypertension in obese and overweight children. As BMI increases, the incidence of WCH also increases. Given these results, we emphasize the importance of ambulatory blood pressure monitoring in the management of pediatric hypertension with overweight and obese patients.