THE FEATURES OF THE CIRCADIAN RHYTHM OF BLOOD PRESSURE IN CHILDREN WITH VASOVAGAL SYNCOPE
DOI:
https://doi.org/10.11603/24116-4944.2020.1.11477Keywords:
vasovagal syncope, ambulatory blood pressure monitoring, white coat hypertension, childrenAbstract
The aim of the study – to determine the features of the circadian rhythm of blood pressure in children with vasovagal syncope using the method of ambulatory blood pressure monitoring.
Materials and Methods. The main group consisted of 65 children aged 8–17 years with a diagnosis of vasovagal syncope. The control group included 41 healthy children of the same age without signs of acute or chronic diseases. The criteria of the European Association of Cardiologists 2018 were used for diagnosing of vasovagal syncope. All surveys conducted ambulatory blood pressure monitoring using an oscillometric monitor VAT41-2 (Ukraine) for 24 hours under normal daily functioning.
Results and Discussion. Children of two groups were comparable in terms of demographic and clinical indicators, which helped to reduce the impact of gender, age, underweight, overweight, and obesity on blood pressure. No differences in the prevalence of day and night systolic and diastolic hypertension in children of two groups were registered. Blood pressure variability did not change depending on the presence of at least one episode of vasovagal syncope in the anamnesis during the last month. White coat hypertension was diagnosed in 10 (15.4 %) patients with vasovagal syncope compared with 1 (2.4 %) child in the control group (p = 0.0333). Analysis of circadian rhythms showed that in the group of vasovagal syncope, the optimal nocturnal fall in blood pressure (dippers) was in 46.2 % of patients for systolic blood pressure and 60.0 % for diastolic blood pressure. In 47.7 % of subjects was found non-dippers type of nocturnal systolic blood pressure fall, which was significantly higher compared to the control group (p=0.0078).
Conclusions. The 24-hours, day and night profiles of systolic, diastolic, mean and pulse blood pressure in patients with vasovagal syncope and in healthy children do not differ. White coat hypertension is more commonly diagnosed in patients with vasovagal syncope than in healthy respondents and may indicate reduced stress resistance. The prevalence of the non-dippers nocturnal systolic blood pressure fall is 47.7 % and is evidence of the autonomic dysfunction in children with vasovagal syncope.
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