421 - Prevalence of Sustained, White Coat and Masked Hypertension in Children Aged 6-12 Years: A Pediatric Nephrology Research Consortium (PNRC) Study

Publication Number: 1404.421

Afsana Jahan, Cohen Children's Medical Center, Franklin square, NY, United States; Meghan McLaughlin, University of Rochester, Rochester, NY, United States; Mahie Abdullah, Cohen Children's Medical Center, New Hyde Park, NY, United States; Emilia Maria Cadiz, Phoenix Children's Hospital, Phoenix, AZ, United States; Eshanika Manchanda, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States; Aftab Chishti, University of Kentucky College of Medicine, Lexington, KY, United States; Maggie Murphy, University of Kentucky College of Medicine, Lexington, KY, United States; Sarah Twichell, Robert Larner, M.D., College of Medicine at the University of Vermont, Burlington, VT, United States; Alexandra Mazo, New York Medical College, White Plains, NY, United States; Dmitry Samsonov, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States; Aesha Maniar, Levine Children's Hospital, Charlotte, NC, United States; Hannah Kim, Weill Cornell Medicine, New York, NY, United States; Francis Lomanta, Primary Children's Hospital, Salt Lake City, UT, United States; Ashok Chakravarthy Patibandla, University of Oklahoma Health Campus, Oklahoma, OK, United States; Matthew Schuchman, Cohen Children's Medical Center, New Hyde Park, NY, United States; Rachel Frank, Northwell Health, NEW HYDE PARK, NY, United States; Tarak Srivastava, Children's Mercy Hospital, Kansas City, MO, United States; ikuyo yamaguchi, The University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, OK, United States; Christine Sethna, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: Ambulatory blood pressure monitoring (ABPM) is recommended by the 2022 American Heart Association (AHA) guidelines as the gold standard for diagnosing hypertension in children. However, limited data exists on the prevalence and distribution of hypertension phenotypes in young children.

Objective: The current study aims to study the various hypertension phenotypes in children of 6-12 years of age.

Design/Methods: A multicenter retrospective chart review was conducted across 11 PNRC sites on children aged 6–12 years in whom ABPM and echocardiography were performed within 3-months of each other and had available clinic blood pressure (BP). Those with congenital heart disease or those who were on anti-hypertensives for more than one month during the ABPM were excluded. Hypertension phenotypes were categorized as sustained, masked, white coat or normotension as defined by 2022 AHA guidelines. Demographic and clinical characteristics, including the prevalence of left ventricular hypertrophy (LVH, defined as left ventricular mass index ≥95th percentile for age and sex) were analyzed across the hypertensive phenotypes using descriptive statistics.

Results: Among 162 children included in the analysis, 60.5% were found to have hypertension (20.4% with masked hypertension and 40.1% with sustained hypertension). The prevalence of white coat hypertension was 18.5%. Chronic kidney disease (CKD) was present in 21.6% of participants. Left ventricular hypertrophy (LVH) was observed in 24.7% of children overall and in approximately 22.5 % of those with white-coat hypertension. Isolated nocturnal hypertension was found in 16.7% of children and nocturnal non dipping was found in 47.5% of all blood pressure phenotypes. The clinical profile across different BP phenotypes is summarized in the Table 1.

Conclusion(s): In this large multicenter cohort of children aged 6–12 years, ambulatory hypertension was frequent, especially nocturnal hypertension. Notably, LVH was also common among those with white-coat hypertension. These findings highlight the importance of future prospective studies to understand the cardiovascular outcome of different hypertension phenotypes, especially nocturnal and white coat hypertension.

Curriculum vitae
CV _ Afsana -November_2025.pdf