Essential hypertension vs. secondary hypertension among children.

Abstract:

BACKGROUND:The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. METHODS:We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. RESULTS:We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P < 0.0001), and lower prevalence of preterm birth (20% vs. 46%; P < 0.001). There was a bimodal distribution of age of diagnosis in those with secondary hypertension. CONCLUSIONS:The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth.

journal_name

Am J Hypertens

authors

Gupta-Malhotra M,Banker A,Shete S,Hashmi SS,Tyson JE,Barratt MS,Hecht JT,Milewicz DM,Boerwinkle E

doi

10.1093/ajh/hpu083

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

73-80

issue

1

eissn

0895-7061

issn

1941-7225

pii

hpu083

journal_volume

28

pub_type

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