Ambulatory Blood Pressure Monitoring for Children With Beta–Thalassemia Major: a Preliminary Report

Abstract

Introduction. Heart disease is one of the most common reasons of death in beta-thalassemia major. A few studies have been done in children about blood pressure changes. The aim of this study was to assess hemodynamic changes by ambulatory blood pressure monitoring (ABPM).

Materials and Methods. In this cross-sectional study, 30 patients with beta-thalassemia major aged 5 to 18 years old were evaluated with 24-hour ABPM. The exclusion criteria were an ejection Fraction less than 50% and a glomerular filtration rate less than 90 mL/min/1.73 m². Hypertension was defined as a mean blood pressure index of 1 and greater with or without load blood pressure greater than 25%. Dipper status was defined as a 10% decrease in nighttime versus daytime mean arterial blood pressure.

Results. High blood pressure was detected in 16.7% of the patients. The whole-day ABPM showed hypertension in 6.7% of the children. During daytime measurements, systolic hypertension was seen in 3.3% (load 3.7%) and diastolic in 6.7% (load 3.3%). These figures for nighttime evaluation were 6.7% (load 3.3%) and 10.3% (load 6.9%), respectively. Nondipper status was detected in 56.7% of the children. There was no significant correlation between abnormal blood pressure and age, sex, body mass index, hemoglobin, number or rates of blood transfusion, or serum ferritin level.

Conclusions. The ABPM may be a useful instrument for early detection of hemodynamic changes in children with beta-thalassemia major.