Sustained hypertension with nocturnal hypertension
This is a 14-year-old boy with a kidney transplant.
- The home and clinic blood pressures have consistently been in the low 120s mm Hg systolic and 70s diastolic.
- The ambulatory pressures were set at the 90th percentile (transplant patient) at awake 124/80 mm Hg and asleep 112/72 mm Hg.
Summary sheet for 24-hour ABPM study:
| Statistical Summary |
Overall |
Awake |
Sleeping |
| Mean |
SD |
Range |
Mean |
SD |
Range |
Mean |
SD |
Range |
| Systolic |
137 |
9.51 |
116-162 |
137 |
10.01 |
116-162 |
139 |
3.06 |
136-144 |
| Diastolic |
93 |
7.94 |
75-110 |
93 |
8.24 |
75-110 |
93 |
5.29 |
84-99 |
| BP Load: Percent of readings above normal limits |
% Sleep Decline |
|
Awake |
Sleeping |
| Systolic |
74 |
100 |
-1.4 |
| Diastolic |
96 |
100 |
0.1 |
Reference
Values |
Normal <25%
Intermediate 25%-50%
Abnormal >50% |
Normal ≥ 10% |
SD = Standard Deviation
Impression/Plan:
This study shows severe ambulatory hypertension with severe nocturnal hypertension and reversed nocturnal dipping. None of his BP readings are normal, either while awake or asleep. He has masked hypertension. The study shows sustained awake and asleep systolic hypertension and diastolic hypertension with reduced nocturnal dip. This patient requires immediate anti-hypertensive drug therapy.