Hypertension and obstructive sleep apnea in Caucasian children

AIM:To evaluate the prevalence of hypertension and/or left ventricular hypertrophy(LVH) in children with a diagnosis of obstructive sleep apnea(OSA).METHODS:A cross-sectional case series of consecutive,otherwise healthy children aged > 4 years,with polysomnography-proven OSA [apnea hypopnea index(AHI) > 1.5/h] is described.Echocardiography was performed on all subjects and left ventricular mass was calculated.Study subjects underwent additional investigation with 24-h ambulatory blood pressure(BP) monitoring.RESULTS:Thirty children(21 males) were studied.Mean age was 8.9 years.Mean body mass index was 19.87 kg/cm2.Mean AHI was 14.3/h.10/30(33%) of the study population met criteria for pre-hypertension(n = 3) or masked hypertension(n = 7) based on standard ambulatory monitoring criteria.All 10 children had systolic hypertension throughout the night with 5 of these also having elevated daytime systolic readings.There was a relationship between AHI and BP showing an increase of 1.162 percentile units in mean diastolic night BP(age,gender and height specific) per unit increase in AHI(P = 0.018).There were no subjects with LVH and/or right ventricular hypertrophy.CONCLUSION:In our population of otherwise healthy Caucasian children,there was a high prevalence of hypertension that would not have been identified using standard office/clinic protocols.