P002 MICROALBUMINURIA PREDICTS MASKED HYPERTENSION IN CHILDREN WITH OVERWEIGHT AND OBESITY

Introduction: Childhood overweight and obesity are known modifiable risk factors linked to the several forms of hypertension, including Masked Hypertension (MH). However, which are clinical predictors of MH in this special population is not know. Ambulatory blood pressure (ABP) is more often associated with early target organ damage, specifically, microalbuminuria, than on office blood pressure (OBP). Objective To evaluate the presence of predictors of MH in children with overweight and obesity. Material and methods: Cross-sectional, analytical study. Children aged 5 to 16 years with overweight and obesity who consulted two tertiary hospitals in the Autonomous City of Buenos Aires. A standardized clinical history, OBP (Riester model aneroid blood pressure monitor) with a protocolized technique and Ambulatory Blood Pressure Monitoring (ABPM) (Spacelabs 90207 y 90217) were performed. Several clinical and analytical variables, including Microalbuminuria dyslipidemia and insulin resistance were investigated. Statistical models to predict ambulatory arterial hypertension (HTN) and MH were carried out using the SAS 9.4 software. Results: A total of 409 children were included, median age 11.36 years, 236 males (57.7%); 301 (73.6%) were found to be normotensive, 42 (10.2%) with white coat HTN, 66 (16.1%) had some form of ambulatory HTN: 27 (6%) with true HTN, 39 (9.5%) with MH. Of the total, 6 (1.5%) presented isolated nocturnal HTN. and The median BMI was 28.36. The univariate and multivariate regression models, adjusted for age and sex, showed systolic OBP (OR 1.1, p<0.001) and microalbuminuria (OR 3.37, p=0.03) as independent predictors of ambulatory HTN. The presence of microalbuminuria was the only predictor of MH in obese children (OR 3.6, p<0,01). Conclusions: A prevalence of 9.5% of MH was identified in the overweight and obese pediatric population. The predictors of ambulatory HTN were systolic OBP and microalbuminuria. The latter being the only predictor of MH in this population. The timely detection of MH and predictors, especially microalbuminuria, in this population shows the importance of using ABPM in pediatrics. Table 1: Sample characteristics