Abstract：
Masked hypertension (MH) occurs when office blood pressure is normal, but hypertension is confirmed using out-of-office blood pressure measures. Hypertension is a risk factor for subclinical cardiovascular outcomes, including left ventricular hypertrophy, increased left ventricular mass index, carotid intima media thickness, and pulse wave velocity. However, the risk factors for ambulatory blood pressure monitoring defined MH and its association with subclinical cardiovascular outcomes are unclear. A systematic literature search on 9 databases included English publications from 1974 to 2023. Pediatric MH prevalence was stratified by disease comorbidities and compared with the general pediatric population. We also compared the prevalence of left ventricular hypertrophy, and mean differences in left ventricular mass index, carotid intima media thickness, and pulse wave velocity between MH versus normotensive pediatric patients. Of 2199 screened studies, 136 studies (n=28 612; ages 4-25 years) were included. The prevalence of MH in the general pediatric population was 10.4% (95% CI, 8.00-12.80). Compared with the general pediatric population, the risk ratio (RR) of MH was significantly greater in children with coarctation of the aorta (RR, 1.91), solid-organ or stem-cell transplant (RR, 2.34), chronic kidney disease (RR, 2.44), and sickle cell disease (RR, 1.33). MH patients had increased risk of subclinical cardiovascular outcomes compared with normotensive patients, including higher left ventricular mass index (mean difference, 3.86 g/m2.7 [95% CI, 2.51-5.22]), left ventricular hypertrophy (odds ratio, 2.44 [95% CI, 1.50-3.96]), and higher pulse wave velocity (mean difference, 0.30 m/s [95% CI, 0.14-0.45]). The prevalence of MH is significantly elevated among children with various comorbidities. Children with MH have evidence of subclinical cardiovascular outcomes, which increases their risk of long-term cardiovascular disease.
摘要：
隐性高血压（MH）发生在办公室血压正常时，但是高血压是通过办公室外的血压测量来证实的。高血压是亚临床心血管结局的危险因素，包括左心室肥厚,左心室质量指数增加，颈动脉内膜中层厚度，和脉搏波速度。然而,动态血压监测定义为MH的危险因素及其与亚临床心血管结局的关联尚不清楚.对9个数据库进行了系统的文献检索，包括1974年至2023年的英文出版物。儿科MH患病率按疾病合并症分层，并与普通儿科人群进行比较。我们还比较了左心室肥厚的患病率，和左心室质量指数的平均差异，颈动脉内膜中层厚度，MH与血压正常的儿科患者之间的脉搏波速度。在2199项筛查研究中，纳入136项研究（n=28612；年龄4-25岁）。MH在普通儿科人群中的患病率为10.4%(95%CI,8.00-12.80)。与普通儿科人群相比，在主动脉缩窄的儿童中，MH的风险比（RR，1.91),实体器官或干细胞移植(RR，2.34),慢性肾脏病（RR，2.44),和镰状细胞病(RR，1.33).与血压正常的患者相比，MH患者亚临床心血管结局的风险增加，包括较高的左心室质量指数(平均差，3.86g/m2.7[95%CI，2.51-5.22])，左心室肥厚（比值比，2.44[95%CI，1.50-3.96])，和更高的脉搏波速度(平均差，0.30m/s[95%CI，0.14-0.45])。在患有各种合并症的儿童中，MH的患病率显着升高。MH患儿有亚临床心血管结局的证据，这增加了他们长期心血管疾病的风险。
