High Blood Pressure Reveals Complications Risk in Children

Arterial hypertension determined by ambulatory blood pressure profiles: contribution to microalbuminuria risk in a multicenter investigation in 2,105 children and adolescents with type 1 diabetes, by Axel Dost and colleagues. Diabetes Care 31:720-725, 2008

What is the problem and what is known about it so far?

High blood pressure is a major risk factor for the development of complications in type 1 diabetes. Studies have shown that high blood pressure is common in adult diabetic patients and have revealed links between blood pressure and urine protein, a sign of kidney disease. However, blood pressure studies in children have been limited and have had mixed results.

Why did researchers do this particular study?

The researchers wanted to find out which factors influence the development of high blood pressure and urine protein in diabetic children.

Who was studied?

Subjects included 2,105 children and adolescents with type 1 diabetes from a national database of patients in medical centers throughout Germany and Austria.

How was the study done?

Researchers performed ambulatory blood pressure monitoring on subjects, which allows blood pressure to be monitored throughout the day and night in an individual’s usual surroundings. They then analyzed results compared to healthy German children.

What did the researchers find?

Age-related changes in blood pressure occur in both diabetic and nondiabetic children, but they happen 15-20 years earlier in those with diabetes. In diabetic children, nighttime blood pressure is abnormally high, and "dipping" (the normal nighttime drop in blood pressure) is reduced. Age, diabetes duration, sex, body mass index, A1C level, and insulin dose are all related to abnormalities in children’s overall blood pressure profiles, although dipping is only related to age, female sex, and A1C level. Nighttime high blood pressure and impaired dipping contribute to the development of complications in children.

What are the implications of the study?

Ambulatory blood pressure measurement may help identify blood pressure problems at their earliest and most treatable stages, which could help prevent the development of diabetes complications in children.

FOR MORE INFORMATION

High blood pressure and diabetes

Diabetes and kidney disease

Diabetes Complications