Benefits of ambulatory blood pressure monitoring over office blood pressure in children and adolescents with severe obesity: findings from the bern obesity in childhood and adolescence biorepository

Alexander Koch; Hyntie Cui; Sibylle Tschumi; Giacomo Simonetti; Markus Juonala; Matthias Kopp; Marco Janner; Christoph Saner

doi:10.1530/endoabs.110.P660

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Endocrine Abstracts (2025) 110 P660 | DOI: 10.1530/endoabs.110.P660

ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)

Benefits of ambulatory blood pressure monitoring over office blood pressure in children and adolescents with severe obesity: findings from the bern obesity in childhood and adolescence biorepository

Alexander Koch ¹ , 2 , Hyntie Cui ¹ , Sibylle Tschumi ³ , Giacomo Simonetti ⁴ , 5 , Markus Juonala ⁶ , 7 , Matthias Kopp ⁸ , Marco Janner ^{1 & Christoph Saner} & 9

Author affiliations

¹Inselspital, Bern University Hospital, University of Bern, Division of Paediatric Endocrinology, Diabetology and Metabolism, Department of Paediatrics, Bern, Switzerland; ²University of Bern, Graduate School for Health Sciences, Bern, Switzerland; ³Inselspital, Bern University Hospital, University of Bern, Division of Paediatric Nephrology, Department of Paediatrics, Bern, Switzerland; ⁴Ospedale San Giovanni, Ente Ospedaliero Cantonale, Pediatric Institute of Southern Switzerland, Bellinzona, Switzerland; ⁵Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland; ⁶Turku University Hospital, Division of Medicine, Turku, Finland; ⁷University of Turku, Department of Medicine, Turku, Finland; ⁸Inselspital, Bern University Hospital, University of Bern, Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland; ⁹The Royal Children’s Hospital, Murdoch Children’s Research Institute, Parkville, Victoria, Australia

JOINT846

Background: Prevalence of hypertension (HTN) among children and adolescents with severe obesity is up to five times higher compared to their normal-weight peers. Youth hypertension is a strong predictor of cardiovascular (CV) morbidity and premature mortality. Ambulatory blood pressure monitoring (ABPM) has proven superior to office blood pressure (oBP) for diagnosis and CV risk prediction in adults. Growing evidence supports its use in the paediatric population. However, data on ABPM in children and adolescents with severe obesity and associations with measures of mass and body composition remain sparse.

Methods: Data on anthropometry (percent of the 95^th body mass index percentile according to CDC [%BMIp95], waist-to-height ratio [WHtR], impedance-related percent of body fat [%BF] and muscle mass [%MM]) as predictors, and on oBP and 24-hour ABPM as outcomes (normal BP, ambulatory HTN, white coat HTN [WCH] and masked HTN [MH], non-dipping) according to ESH guidelines were drawn from the Bern Obesity in Childhood and Adolescence Biorepository. Descriptive statistics and adjusted logistic regression analyses were applied.

Results: A total of 351 individuals, 52. 4% males, had a mean (SD) age of 12. 2 (2. 6) years and a %BMIp95 of 124 (17. 9). WHtR (n = 316) was 0. 58 (0. 06), %BF and %MM (n = 241) was 41. 9% (6. 4) and 31. 7% (3. 7), respectively. Based on oBP measurements (n = 302), 8% had Grade 1 HTN, 9% had Grade 2 HTN. Based on ABPM (n = 351), 15% had ambulatory HTN and 44% were non-dippers. In 302 participants with oBP and ABPM, ABPM detected WCH in 36 of 52 individuals with abnormal oBP, and MH in 28 of 251 individuals with normal oBP, overall disproving 21% of oBP findings. An increase in 1-unit %BMIp95 and 0. 01-unit WHtR was associated with ambulatory HTN (OR 1. 02 [1. 01-1. 04] and 1. 07 [1. 01-1. 13], respectively). An increase in 1-unit %BF was associated with non-dipping (1. 05 [1. 01-1. 10]), whereas a 1-unit increase in %MM was protective from non-dipping (0. 91 [0. 84-0. 98]).

Conclusion: Our results provide evidence for the benefits of ABPM in children and adolescents with severe obesity for discriminating BP subtypes and for risk stratification, and we show that body composition measures provide distinct information on blood pressure outcomes.