Prevalence and predictors of ambulatory blood pressure monitoring-detected hypertension in children and adolescents with type 1 diabetes.

BACKGROUND

Hypertension accelerates both microvascular and macrovascular complications in patients with diabetes. Despite the growing burden of diabetes and cardiovascular risk, data from low-resource countries on 24-h ambulatory blood pressure monitoring (ABPM)-detected hypertension in children and adolescents with type 1 diabetes mellitus (T1DM) remain limited.

METHODS

This cross-sectional study enrolled Thai children and adolescents with T1DM aged 8-18 years to perform 24-h ABPM. Clinical data included current diabetes status (HbA1c level and insulin regimen) and metabolic parameters (body mass index [BMI], waist-to-height ratio, and lipid profiles). Historical diabetes data and glycemic control over the previous year were retrospectively reviewed. Hypertension was defined according to the 2022 American Heart Association guidelines. Logistic regression analysis was used to identify independent predictors of ABPM hypertension.

RESULTS

A total of 100 patients were included, with a median age of 13.9 years (interquartile range [IQR]: 11.7-15.9) and a median diabetes duration of 5.1 years (IQR: 2.1-7.3). ABPM detected hypertension in 37% of patients. The majority (78.4%) exhibited hypertension during nighttime, and isolated nocturnal hypertension was present in 32.4% of ABPM hypertension cases. Multivariable analysis identified male sex (adjusted odds ratio [aOR] 3.00; p = 0.02), and obesity (BMI Z-score > 2) (aOR 2.72; p = 0.04) as independent predictors of ABPM hypertension.

CONCLUSIONS

ABPM-detected hypertension is common among Thai children and adolescents with T1DM. In resource-constrained environments, ABPM screening should be considered in high-risk patients, male sex or obese, to facilitate early detection and targeted interventions aimed at reducing long-term cardiovascular risk.