Hypertension in Children: A Single Center Experience

Uysal, Berfin; Uysal, Fahrettin

doi:10.23937/2474-3690/1510027

Cited by 4 publications

(8 citation statements)

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“…In our cohort most of our patients (80%) had secondary hypertension and 26 (20%) had primary hypertension.Similar proportions were reported by Uhari et al where they nd that 82% of children had secondary hypertension while primary hypertension was seen in 18 % of children (9). In another retrospective cross-sectional study involved 231 hypertensive patients aged one to twenty years, 50.6% were found to have primary hypertension whereas 49.4% of them were classi ed as secondary hypertension ( 10), a nding that is replicated by another multi center clinical trial by Flynn J et al (11). The patients included in our study were electively referred to our center for hypertension and many of them have chronic kidney disease which explains the low rate of primary hypertension.In our study, consanguinity is common among both groups of which was seen in 64(62%) in children with secondary hypertension and 13(50%) in children with primary hypertension, a rate that is consistant with an overall high consaginous marrriage rate in Oman smilar to other Middle Eastern countries (12,13,14,).…”

Section: Discussionmentioning

confidence: 55%

“…This can be attributed to high rate of hereditary renal disease as a cause of CKD leading to secondary hypertension by which more than one member of the same family is affected. In a previous report, family history was present in only 27 (11.7%) of cases and was more common in primary hypertension 20(20.6%) compared to secondary hypertension (10). It is well known that genetic factors are important in the pathogenesis of hypeternion as primary hypertension is commonly seen among parents and siblings and it is also seen among identical twins if one of them is hypertensive (15,16).…”

Section: Discussionmentioning

confidence: 95%

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Etiology, treatment and complications of childhood hypertension : A retrospective study

Riyami

2024

Preprint

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Background Hypertension is common in children, with an estimated prevalence of about 2–5%, and is increasing worldwide. This study reports a single-center experience of hypertension in children Methods A retrospective chart review of children aged from one month to 13 years old who were diagnosed with hypertension. Results A total of 129 children were included. Secondary hypertension was seen in 103 (79.8%) patients compared to only 26 (20.2%) who had primary hypertension. Primary hypertension was more common among pre-teen children (50.0%), whereas a higher proportion of the cases with secondary hypertension were aged between 1–5 years. Renal parenchymal diseases were the most common etiology for secondary hypertension, followed by endocrine and then vascular causes. In this study, no significant association was noted between hypertension and obesity. The most common complications of hypertension in these children were cardiovascular complications, followed by neurological complications. Hypertension was only managed by lifestyle modification in 14.7% of children, while the rest were also started on antihypertensive medications. During the last follow-up, 50% of children had improvement in blood pressure readings." Conclusion Secondary hypertension is more common compared to primary hypertension in our patients. The results of this study will increase awareness among pediatricians about the importance of early recognition and management of hypertension. Larger population-based studies are needed to better assess the prevalence, causes, and outcomes of hypertension in our region.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 95%

Etiology, treatment and complications of childhood hypertension : A retrospective study

Riyami

2024

Preprint

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“…The individual study methods, study populations, inclusion and exclusion criteria, and proportions of children and adolescents with secondary hypertension are described in eTable 2 in the Supplement. Most studies 4,5,[15][16][17][18][19][20][21]23,[35][36][37][38][39][40][41][42] were retrospective cohorts of consecutive children and adolescents referred to pediatric nephrology or pediatric hypertension clinics. Five studies [43][44][45][46][47] were retrospective cohorts of children and adolescents who had 24-hour ambulatory blood pressure monitoring.…”

Section: Study Characteristicsmentioning

confidence: 99%

Does This Child With High Blood Pressure Have Secondary Hypertension?

Nugent

Jiang

Funaro

et al. 2023

JAMA

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ImportanceGuidelines recommend that all children and adolescents with hypertension undergo evaluation for secondary causes. Identifying clinical factors associated with secondary hypertension may decrease unnecessary testing for those with primary hypertension.ObjectiveTo determine the utility of the clinical history, physical examination, and 24-hour ambulatory blood pressure monitoring for differentiating primary hypertension from secondary hypertension in children and adolescents (aged ≤21 years).Data Sources and Study SelectionThe databases of MEDLINE, PubMed Central, Embase, Web of Science, and Cochrane Library were searched from inception to January 2022 without language limits. Two authors identified studies describing clinical characteristics in children and adolescents with primary and secondary hypertension.Data Extraction and SynthesisFor each clinical finding in each study, a 2 × 2 table was created that included the number of patients with and without the finding who had primary vs secondary hypertension. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool.Main Outcomes and MeasuresRandom-effects modeling was used to calculate sensitivity, specificity, and likelihood ratios (LRs).ResultsOf 3254 unique titles and abstracts screened, 30 studies met inclusion criteria for the meta-analysis and 23 (N = 4210 children and adolescents) were used for pooling in the meta-analysis. In the 3 studies conducted at primary care clinics or school-based screening clinics, the prevalence of secondary hypertension was 9.0% (95% CI, 4.5%-15.0%). In the 20 studies conducted at subspecialty clinics, the prevalence of secondary hypertension was 44% (95% CI, 36%-53%). The demographic findings most strongly associated with secondary hypertension were family history of secondary hypertension (sensitivity, 0.46; specificity, 0.90; LR, 4.7 [95% CI, 2.9-7.6]), weight in the 10th percentile or lower for age and sex (sensitivity, 0.27; specificity, 0.94; LR, 4.5 [95% CI, 1.2-18]), history of prematurity (sensitivity range, 0.17-0.33; specificity range, 0.86-0.94; LR range, 2.3-2.8), and age of 6 years or younger (sensitivity range, 0.25-0.36; specificity range, 0.86-0.88; LR range, 2.2-2.6). Laboratory studies most associated with secondary hypertension were microalbuminuria (sensitivity, 0.13; specificity, 0.99; LR, 13 [95% CI, 3.1-53]) and serum uric acid concentration of 5.5 mg/dL or lower (sensitivity range, 0.70-0.73; specificity range, 0.65-0.89; LR range, 2.1-6.3). Increased daytime diastolic blood pressure load combined with increased nocturnal systolic blood pressure load on 24-hour ambulatory blood pressure monitoring was associated with secondary hypertension (sensitivity, 0.40; specificity, 0.82; LR, 4.8 [95% CI, 1.2-20]). Findings associated with a decreased likelihood of secondary hypertension were asymptomatic presentation (LR range, 0.19-0.36), obesity (LR, 0.34 [95% CI, 0.13-0.90]), and family history of any hypertension (LR, 0.42 [95% CI, 0.30-0.57]). Hypertension stage, headache, and left ventricular hypertrophy did not distinguish secondary from primary hypertension.Conclusions and RelevanceFamily history of secondary hypertension, younger age, lower body weight, and increased blood pressure load using 24-hour ambulatory blood pressure monitoring were associated with a higher likelihood of secondary hypertension. No individual sign or symptom definitively differentiates secondary hypertension from primary hypertension.

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“…Common ovarian pathologies in childhood and youth are reported as usually asymptomatic and they emerge only when complications occur, such as acute abdomen or a palpable mass in the ovarian lodge [6]. Unlike these situations, PCOS manifestation and complications include a broad group of manifestations, affecting both fertility and the metabolic profile.…”

Section: Introductionmentioning

confidence: 99%

The Role of the Gut Microbiome in Youth with Polycystic Ovary Syndrome: A Systematic Review

Tsinopoulou,

Kotanidou,

Athanasiadis

et al. 2023

Children

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Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age and female adolescents. The diagnosis of PCOS is difficult during puberty due to overlapping of the criteria with normal variations of menstruation during this age period. There are insufficient data on the gut microbiome and PCOS and potential mechanisms linking the two. The present systematic review aimed to detect dysbiosis patterns in youth with PCOS, compared with healthy controls. Methods: One hundred seventy-eight studies were identified by a databases search and sixty-eight by a full-text assessment for eligibility; four were included in the systematic review and underwent quality control. Results: The results of the study were controversial in accordance to findings from the literature. A change in gut microbiome α diversity was found in PCOS adolescents, with no significant alterations in β diversity. Almost all studies found Firmicutes, Bacteroidetes, and Actinobacteria in abundance in both groups, with changes in family composition and fluctuations at the phylum level. A statistically significant association between these changes and clinical or biochemical features of the syndrome was described. Conclusions: This systematic review confirmed gut microbiota dysbiosis in youth with PCOS. However, further data are needed to clarify these changes and to build a strategy to prevent the syndrome.

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Hypertension in Children: A Single Center Experience

Cited by 4 publications

References 16 publications

Etiology, treatment and complications of childhood hypertension : A retrospective study

Etiology, treatment and complications of childhood hypertension : A retrospective study

Does This Child With High Blood Pressure Have Secondary Hypertension?

The Role of the Gut Microbiome in Youth with Polycystic Ovary Syndrome: A Systematic Review

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