Key result
Higher BP variability links to POTS, with females facing ~13-fold greater risk of poor prognosis.
Why the study?
Differences in blood pressure variability between children with postural tachycardia syndrome and healthy children, and its effect on prognosis, remained to be determined.
Is blood pressure variability increased in children with POTS compared to healthy controls, and does it predict prognosis?
Case-Control (n=77)
Is blood pressure variability increased in children with POTS compared to healthy controls, and does it predict prognosis?
Effect estimate: OR 12.99
p-value: p=< 0.05
Children with POTS exhibit increased blood pressure variability compared to healthy controls, and female sex is strongly associated with poor short-term prognosis.
May support BP variability monitoring for pediatric POTS risk stratification; leaves open causal role and need for prospective trials.
(1) Objective: In this research, we explored the difference in blood pressure variability (BPV) between children with postural tachycardia syndrome (POTS) and healthy children. Furthermore, we tried to investigate the effect of BPV on POTS and its relationship with prognosis of POTS. (2) Methods: 47 children with POTS (11.2 ± 1.8 years, 23 males) were enrolled in the POTS group and 30 healthy children (10.9 ± 1.9 years, 15 males) were matched for the control group. All participants completed 24 h ambulatory blood pressure monitoring (24hABPM). Thirty-three children with POTS were followed up for 52.0 (30.5, 90.5) days and were divided into a response group and a non-response group after evaluation. (3) Results: The 24 h diastolic blood pressure standard deviation (24hDSD), daytime diastolic blood pressure standard deviation (DDSD), nighttime systolic blood pressure standard deviation (NSSD), daytime diastolic blood pressure variation coefficient (DDCV) and nighttime systolic blood pressure variation coefficient (NSCV) in the control group were lower than those in the POTS group (p < 0.05). Percentage of females, age and height were lower in the response group than in the non-response group in children with POTS (p < 0.05). Univariate analysis showed that 24hDSD, DDSD, NSSD, DDCV and NSCV were potential risk factors for POTS, and sex and height were potential risk factors for poor prognosis of POTS. After adjusting for covariates, the risk of POTS increased by 48%, 53% and 49% when DDSD, NSSD and NSCV increased by 1 mmHg, 1 mmHg and 1%, respectively. The risk of poor prognosis in females was 12.99 times higher than that in males. (4) Conclusions: The results suggest that children with POTS may have an abnormal circadian rhythm in blood pressure and increased BPV. DDSD, NSSD and NSCV are independent risk factors for POTS, and being female is an independent risk factor for poor prognosis of POTS.
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Gu et al. (2023) conducted a case-control in Postural Tachycardia Syndrome (POTS) (n=77). Blood pressure variability (BPV) vs. Healthy children was evaluated on Risk of POTS and poor prognosis (OR 12.99, p=< 0.05). Increased daytime diastolic and nighttime systolic blood pressure variability are independent risk factors for POTS, and being female is associated with a 12.99 times higher risk of poor prognosis.
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