Albuminuria and masked hypertension in overweight and obese children and adolescents: A cross-sectional study

Introduction. Childhood overweight and obesity are known risk factors linked to the development of masked hypertension (MH). These factors may have a greater impact on ambulatory blood pressure (BP) than on office BP and be associated with early target organ damage. Objective. To evaluate the presence of markers of MH in an overweight and obese pediatric population. Population and methods. An analytical, observational, cross-sectional study was performed. Overweight and obese children aged 5 to 16 years who consulted at two tertiary hospitals in the Autonomous City of Buenos Aires were included. Office blood pressure and ambulatory blood pressure monitoring (ABPM) were recorded. Clinical and anthropometric parameters were evaluated, as were the metabolic profile, renal function, and albuminuria. Results. A total of 409 children were included, with a median age of 11.3 years; 236 (57.7%) were male. There were 301 (73.6%) normotensive children, 27 (6%) with true hypertension, 42 (10.2%) with white coat hypertension, and 39 (9.5%) with MH. Univariate and multivariate regression models, adjusted for age and sex, showed an association between ambulatory hypertension and office systolic BP (OR 1.1, p <0.001) and albuminuria (OR 3.37, p = 0.03). The presence of albuminuria was the only predictor of MH in obese individuals (OR 3.6, p <0.01). Conclusion. A significant prevalence of MH was identified in overweight and obese pediatric populations. An association was observed between hypertension, including MH, and the presence of albuminuria in overweight and obese pediatric patients.