{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:13:27Z","timestamp":1787505207088,"version":"build-2736575974"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,7,1]]},"abstract":"<jats:p>Objective. To determine whether ambulatory blood pressure monitoring (ABPM) can help differentiate children with secondary hypertension from those with primary hypertension.<\/jats:p>\n                  <jats:p>Methods. Ninety-seven ABPM studies obtained from 85 children followed in a pediatric hypertension clinic were analyzed. Forty studies were performed in patients with primary hypertension, and 57 studies were performed in patients with secondary hypertension. Mean patient age was 13.8 \u00b1 3.5 [mean \u00b1 standard deviation] years, range 4 to 19.7 years; patients with secondary hypertension were younger and had lower body mass index than patients with primary hypertension.<\/jats:p>\n                  <jats:p>Results. Daytime diastolic and nocturnal systolic blood pressure (BP) loads, defined as the percentage of readings greater than a threshold value, were significantly greater in patients with secondary hypertension compared with patients with primary hypertension. A daytime diastolic BP load of \u226525% and\/or a nocturnal systolic BP load of \u226550% was highly specific for secondary hypertension.<\/jats:p>\n                  <jats:p>Conclusions. Secondary hypertension in childhood is characterized by daytime diastolic BP elevation and nocturnal systolic BP elevation. This pattern of hypertension on ABPM may be a clue to underlying renal or other organ system pathology in children being evaluated for suspected hypertension and could help to identify children who require more detailed evaluation to determine the cause of their hypertension.<\/jats:p>","DOI":"10.1542\/peds.110.1.89","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T20:17:55Z","timestamp":1092428275000},"page":"89-93","source":"Crossref","is-referenced-by-count":93,"title":["Differentiation Between Primary and Secondary Hypertension in Children Using Ambulatory Blood Pressure Monitoring"],"prefix":"10.1542","volume":"110","author":[{"given":"Joseph T.","family":"Flynn","sequence":"first","affiliation":[{"name":"From the Division of Pediatric Nephrology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2002,7,1]]},"reference":[{"key":"2021121006193048000_R1","doi-asserted-by":"crossref","unstructured":"National High Blood Pressure Education Program Task Force on Blood Pressure Control in Children. Report of the Second Task Force on Blood Pressure Control in Children\u20141987. Pediatrics.1987;79:1\u201325","DOI":"10.1542\/peds.79.1.1"},{"key":"2021121006193048000_R2","doi-asserted-by":"crossref","unstructured":"Bartosh SM, Aronson AJ. Childhood hypertension: an update on etiology, diagnosis and treatment. Pediatr Clin N Am.1999;46:235\u2013252","DOI":"10.1016\/S0031-3955(05)70115-2"},{"key":"2021121006193048000_R3","doi-asserted-by":"crossref","unstructured":"Flynn JT. Evaluation and management of hypertension in childhood. Prog Pediatr Cardiol.2001;12:177\u2013188","DOI":"10.1016\/S1058-9813(00)00071-0"},{"key":"2021121006193048000_R4","doi-asserted-by":"crossref","unstructured":"National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Update on the 1987 task force report on high blood pressure in children and adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics.1996;98:649\u2013658","DOI":"10.1542\/peds.98.4.649"},{"key":"2021121006193048000_R5","doi-asserted-by":"crossref","unstructured":"Baumgart P, Walger P, Dorst KG, von Eiff M, Rahn KH, Vetter H. Can secondary hypertension be identified by twenty-four-hour ambulatory pressure monitoring?J Hypertens.1989;7:S25\u2013S28","DOI":"10.1097\/00004872-198904000-00014"},{"key":"2021121006193048000_R6","doi-asserted-by":"crossref","unstructured":"Polonia J, Santos AR, Gama GM, Barros H. Accuracy of twenty-four-hour ambulatory blood pressure monitoring (night-day values) for the diagnosis of secondary hypertension. J Hypertens.1995;13:1738\u20131741","DOI":"10.1097\/00004872-199512010-00042"},{"key":"2021121006193048000_R7","doi-asserted-by":"crossref","unstructured":"Flynn JT. Impact of ambulatory blood pressure monitoring on the management of hypertension in children. Blood Press Monit.2000;5:211\u2013216","DOI":"10.1097\/00126097-200008000-00003"},{"key":"2021121006193048000_R8","doi-asserted-by":"crossref","unstructured":"Portman RJ, Yetman RJ. Clinical uses of ambulatory blood pressure monitoring. Pediatr Nephrol.1994;8:367\u2013376","DOI":"10.1007\/BF00866367"},{"key":"2021121006193048000_R9","unstructured":"Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC Growth Charts: United States. Hyattsville, MD: National Center for Heath Statistics; 2000"},{"key":"2021121006193048000_R10","unstructured":"Alpert BS, Daniels SR. Twenty-four-hour ambulatory blood pressure monitoring: now that technology has come of age\u2014we need to catch up. J Pediatr.1997;130:167\u2013169"},{"key":"2021121006193048000_R11","doi-asserted-by":"crossref","unstructured":"Koch VH, Colli A, Saito MI, et al. Comparison between casual blood pressure and ambulatory blood pressure monitoring parameters in healthy and hypertensive adolescents. Blood Press Monit.2000;5:281\u2013289","DOI":"10.1097\/00126097-200010000-00006"},{"key":"2021121006193048000_R12","doi-asserted-by":"crossref","unstructured":"Middeke M, Klu\u0308glich M, Holzgrave H. Circadian blood pressure rhythm in primary and secondary hypertension. Chronobiology Int.1991;8:451\u2013459","DOI":"10.3109\/07420529109059181"},{"key":"2021121006193048000_R13","doi-asserted-by":"crossref","unstructured":"Lingens N, Dobos E, Witte K, et al. Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation. Pediatr Nephrol.1997;11:23\u201326","DOI":"10.1007\/s004670050226"},{"key":"2021121006193048000_R14","doi-asserted-by":"crossref","unstructured":"Giaconi S, Levanti C, Fommei E, et al. Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. Am J Hypertens.1989;2:259\u2013261","DOI":"10.1093\/ajh\/2.4.259"},{"key":"2021121006193048000_R15","doi-asserted-by":"crossref","unstructured":"Verdecchia P, Schillaci G. Prognostic value of ambulatory blood pressure monitoring. In: White WB, ed. Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics. Totowa, NJ: Humana Press, Inc; 2001:191\u2013218","DOI":"10.1007\/978-1-59259-004-9_9"},{"key":"2021121006193048000_R16","doi-asserted-by":"crossref","unstructured":"Belsha CW, Wells TG, McNiece KL, Seib PM, Plummer JK, Berry PL. Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens.1998;11:410\u2013417","DOI":"10.1016\/S0895-7061(98)00014-4"},{"key":"2021121006193048000_R17","doi-asserted-by":"crossref","unstructured":"Harshfield GA, Pulliam DA, Alpert BS. Ambulatory blood pressure and renal function in healthy children and adolescents. Am J Hypertens.1994;7:282\u2013285","DOI":"10.1093\/ajh\/7.3.282"},{"key":"2021121006193048000_R18","doi-asserted-by":"crossref","unstructured":"Sorof JM, Mielke TR, Portman RJ. Ambulatory blood pressure monitoring data are correlated with LV mass index and predictive of LV hypertrophy in children with hypertension [abstract]. Am J Hypertens.2000;13:39A","DOI":"10.1016\/S0895-7061(00)00392-7"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/110\/1\/89\/1115802\/pe0702000089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/110\/1\/89\/1115802\/pe0702000089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T09:18:46Z","timestamp":1639127926000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/110\/1\/89\/64062\/Differentiation-Between-Primary-and-Secondary"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,7,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2002,7,1]]},"published-print":{"date-parts":[[2002,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.110.1.89","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,7,1]]}}}