HJAR Nov/Dec 2023

48 NOV / DEC 2023 I  HEALTHCARE JOURNAL OF ARKANSAS CHILDREN’S HEALTH The Case for Ambulatory Blood Pressure Monitoring in the Pediatric Population like Spacelabs Healthcare’s OnTrak am- bulatory blood pressure monitors, vali- dated for use with pediatric patients by the Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society. Patients and their caregivers also keep a written diary correlating activity levels with the mea- surements. Because the monitor is worn while sleeping, the journal allows for the notation of events like disrupted sleep pat- terns, which may impact measurements. Evidence shows that ABPM provides a more accurate diagnosis of hypertension than standard clinic or home-measured blood pressure. Data collected from ABPM devices in- cludes the 24-hour average blood pres- sure, the average daytime blood pressure, the average nighttime blood pressure, and the calculated percentage drop in blood pressure at night. As a pediatric nephrologist at Arkansas HYPERTENSION impacts an estimated 1.4 billion people worldwide and contributes to a significant number of premature adult deaths. Reducing the number of prevent- able deaths caused by hypertension is a global target for the World Health Organi- zation. Early and accurate diagnosis of the condition is a crucial step toward that goal. Identification and prevention of hyperten- sion before adulthood is vital. Hypertension has risen in the pediatric population since the 1990s, prompting the “Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents,” published in 2017 by the American Academy of Pediat- rics. The guidelines recommend 24-hour ambulatory blood pressure monitoring (ABPM) for diagnosis. Ambulatory blood pressure moni- toring requires patients to record their blood pressure every 20 to 30 minutes over 24 hours using approved devices COLUMN CHILDREN’S HEALTH Children’s Hospital and associate pro- fessor of pediatrics in the Division of Ne- phrology at the University of Arkansas for Medical Sciences, I have been a part of the ABPM program since its inception at Ar- kansas Children’s Hospital nearly 20 years ago. The number of patients benefitting from the ABPM program at Arkansas Children’s Hospital has more than quadrupled since 2017. Approximately 600 patients are eval- uated yearly using ABPM, including some from neighboring states. ABPM accurately measures blood pres- sure and evaluates for “white-coat” and “masked” hypertension and helps identify the actual hypertensive patient, which can be treated because childhood hyperten- sion has links with adult hypertension. White coat hypertension, in which pa- tients have normal blood pressures at home but elevated blood pressures during office visits, and masked hypertension, in