Ambulatory blood pressure monitoring in children diagnosed with primary headache

Objectives: Patients with primary headache (PH) may have elevated blood pressure (BP) load and/or lack of normal nocturnal BP dipping, even if the office BP measurements are normal, and that may have a role in the etiology. The study aims to evaluate the use of ambulatory blood pressure monitoring (ABPM) in children with PH. Methods: Thirty-seven children aged 8-17 years, who were diagnosed with PH according to the 3rd edition of the International Classification of Headache Disorders (ICHD-3) criteria in pediatric neurology outpatient clinics and had office BP below the 95th percentile, and 37 healthy subjects as a control group were included to this case-control study. Demographic data, office BPs and ABPM results were compared with the control group. Results: Of the 37 patients with the diagnosis of PH, 81% (n=30) had migraine and 19% (n=7) had tension-type headache. There was no significant difference between the age, body-mass index SDS and mean office systolic blood pressure (SBP) SDS values of PH and control group (p=0.86, p=0.35, p=0.14 respectively). In ABPM assessments, total SBP, daytime and nocturnal SBP, nocturnal systolic and diastolic loads were significantly higher in PH group (all p<0.05). No significant difference was detected between the ABPM measures of patients with migraine and tension-type headache. Conclusion: Our findings suggest that ambulatory BP abnormalities may be present in children with PH. Therefore ABPM, an effective and non-invasive tool to detect hypertension and risk groups, should be performed in children diagnosed with PH, even if the office BP measurements are normal.