Children with IIH demonstrated a higher prevalence of ambulatory hypertension, predominantly driven by isolated nocturnal hypertension, despite similar office blood pressure measurements and the absence of overt cardiac target organ damage.
Ambulatory hypertension was significantly more prevalent in children with IIH compared to controls.
Isolated nocturnal hypertension was significantly more frequent in children with IIH and accounted for two-thirds of all ambulatory hypertension cases.
Nighttime diastolic blood pressure load was significantly higher in children with IIH than in controls.
Office blood pressure measurements and mean ambulatory systolic and diastolic blood pressure standard deviation scores did not differ significantly between IIH patients and controls.
Systolic and diastolic dipping patterns were similar between the IIH and control groups.
No significant differences in cardiac structural measures were observed between IIH patients and controls.
This research suggests that children with idiopathic intracranial hypertension (IIH) — a condition involving elevated pressure around the brain without an obvious cause — have significantly higher rates of high blood pressure that only shows up during nighttime sleep, compared to similar children without IIH. In this study of 42 children with IIH and 34 matched controls, about 29% of IIH patients had ambulatory hypertension (high blood pressure detected over a 24-hour period), versus only 6% of controls. Two-thirds of these cases were 'isolated nocturnal hypertension,' meaning blood pressure was only elevated at night and appeared normal during daytime office visits. Importantly, standard doctor's office blood pressure checks appeared normal in both groups, meaning this nighttime hypertension would have been completely missed without 24-hour blood pressure monitoring. Despite the elevated nighttime blood pressure, the children with IIH did not yet show signs of heart damage such as thickening of the heart muscle, suggesting these blood pressure changes may be an early warning sign rather than established disease. This research suggests that 24-hour ambulatory blood pressure monitoring may be a valuable tool in the routine care of children with IIH, since it can identify blood pressure problems that routine measurements cannot detect. IIH has already been linked to greater cardiovascular risk in adults, and these findings raise the possibility that this elevated risk may begin in childhood. Early identification of nocturnal hypertension could open opportunities for monitoring and potentially reducing long-term cardiovascular complications in this patient population.
Baltu D, Dönmez Y, Taş N, Süt N, Orman G, Yılmaz A. (2026). Increased prevalence of ambulatory and isolated nocturnal hypertension in children with idiopathic intracranial hypertension: a case-control study.. European journal of pediatrics. https://doi.org/10.1007/s00431-026-07434-z