Increasing age and primary snoring may be independently associated with hypertension among pediatric patients attending the sleep clinic, with hypertension detected in 41% of patients with complete ambulatory blood pressure monitoring data.
Hypertension was diagnosed in 41% of pediatric sleep clinic patients with complete ABPM data.
Age was independently associated with hypertension in pediatric sleep clinic patients.
Primary snoring was independently associated with hypertension in pediatric sleep clinic patients.
Hypertension prevalence increased with OSA severity but was highest among patients with primary snoring.
A substantial proportion of recruited patients were unable to complete ABPM, limiting the evaluable sample size.
Masked hypertension, which requires ABPM for diagnosis, accounted for nearly half of all hypertension cases detected.
This research suggests that high blood pressure (hypertension) is very common in children referred to a sleep clinic, affecting about 41% of those who completed blood pressure monitoring. The study used a device called a 24-hour ambulatory blood pressure monitor (ABPM), which patients wear throughout the day and night to get a more accurate picture of blood pressure than a single clinic measurement. This approach is important because it can detect 'masked hypertension,' where blood pressure appears normal in the clinic but is actually high at other times — a condition that would otherwise go unnoticed. In this study, nearly half of the hypertensive cases were masked hypertension. Surprisingly, the study found that children with primary snoring — meaning they snore but do not have obstructive sleep apnea (OSA) — actually had the highest rate of hypertension (60%) compared to children with mild, moderate, or severe OSA. Older age and primary snoring were the two factors most strongly and independently linked to hypertension. This challenges the assumption that hypertension risk in sleep clinic patients is driven mainly by OSA severity. This research suggests that routine blood pressure monitoring, ideally with ABPM, may be valuable for all children attending sleep clinics — not just those with the most severe sleep-disordered breathing. The authors caution that the study was small (only 44 patients with complete data) and conducted at a single center, so larger studies are needed to confirm these findings. Nevertheless, the results highlight that primary snoring and increasing age should be considered when assessing cardiovascular risk in pediatric sleep patients.
Leow E, Cheng Z, Wang F, Du R, Ho J, Yap C, et al.. (2026). Risk factors associated with hypertension in patients attending a pediatric sleep clinic: a prospective cohort study.. European journal of pediatrics. https://doi.org/10.1007/s00431-026-07513-1