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Blood pressure after cardiac transplantation in childhood

Lookup NU author(s): Dr John O'Sullivan, Dr Janine Gray


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Background: There has been little formal study of blood pressure in children after cardiac transplantation. Methods: Twenty-four-hour and clinical blood pressure (BP) were measured in 28 children (>6 months after transplantation) and compared with a large amount of normal data. Results: Conventional (clinical) systolic BP (SBP) was elevated in 9 (32.1%) of 28 (95% confidence interval [CI] 15.8 to 52.3), and conventional diastolic BP (DBP) was elevated in 5 (17.8%) of 28 (95% CI 6.0 to 36.8). Mean 24-hour BP was >97.5 percentile in 2 (7.7%) of 26 (95% CI 0.9 to 25.1) for SBP and in 7 (28.0%) of 25 (95% CI 12.1 to 49.4) for DBP. In comparison with the control population, mean nighttime SBP was 8.9 mm Hg higher in the transplanted group (95% CI 4.8 to 13.1), but daytime and mean 24-hour SBP were similar. Mean day, night, and 24-hour DBP was significantly higher in the transplanted patients. The nighttime decrease in BP was significantly less than controls for SBP, but not for DBP. Conventional BP measurement was poorly predictive of 24-hour BP. There was a significant association between mean 24-hour SBP and interventricular septal thickness (r2 = 0.35; p = 0.01). DBP was not associated with interventricular septal thickness (r2 = 0.07; p = 0.20) but was significantly correlated with the time since transplantation (r = 0.42; p = 0.03 for conventional DBP and r = 0.43; p = 0.04 for 24-hour DBP). Conclusions: The elevation of DBP in children after cardiac transplantation is unexplained. The elevation in nighttime SBP has possible important therapeutic implications and is not predicted by conventional (clinical) BP measurement. Copyright © 2005 by the International Society for Heart and Lung Transplantation.

Publication metadata

Author(s): O'Sullivan JJ, Derrick G, Gray J

Publication type: Article

Publication status: Published

Journal: Journal of Heart and Lung Transplantation

Year: 2005

Volume: 24

Issue: 7

Pages: 891-895

Print publication date: 01/07/2005

ISSN (print): 1053-2498

ISSN (electronic): 1557-3117

Publisher: Elsevier


DOI: 10.1016/j.healun.2004.05.025

PubMed id: 15982619


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