Hypertension in children and adolescents

Abstract

Until recently, secondary hypertension used to be the most common form of hypertension in the paediatric population. Due to the increasing prevalence of obesity-related hypertension in children and adolescents, the share of secondary hypertension has decreased from 85% to 9%. Today, primary hypertension has become the dominant form of hypertension in the paediatric population. The purpose of this paper is to show the prevalence of various forms of hypertension and the prevalence of primary hypertension in children and adolescents relative to sex, age and body weight category in the General Hospital "Dr. Laza K. Lazarević" in Šabac. In children with secondary hypertension, the impact of body weight was not assessed since an organic cause of hypertension had been identified in these patients. All children from the age of a new-born to the age of 18 years with a diagnosis of hypertension (International Classification of Diseases, tenth revision (IDC-10), code I10-I15) in the period from 1 January 2013 to 31 December 2022 were selected from the medical digital database. This analysis included all children who showed blood pressure values above 95th percentile for age, sex and height in children under 13 and above 120/80 mmHg in children over 13, upon repeated measurements of blood pressure in the General Hospital, who were presumed to have hypertension. These children were referred to further evaluation at tertiary healthcare institutions, where a diagnosis of hypertension was made. Of the 134 children referred to the General Hospital due to elevated blood pressure levels measured in the primary care physician's office, hypertension was diagnosed in almost one in four subjects (24.6%). Primary hypertension was diagnosed in 18 (54.5%), secondary hypertension in 8 (24.2%) and white coat hypertension in 7 (21.2%) children. Primary hypertension was more common in boys (70.6%) than girls (37.5%). Among children with primary hypertension, overweight and obese children represented 66.7% of the group at the time of diagnosis. Statistical data analysis did not find a statistically significant difference in the prevalence of primary hypertension among the body weight or age categories. Since primary hypertension is the most significant and potentially reversible factor for the development of cardiovascular disease, early detection and treatment of primary hypertension in children is crucial in the prevention of cardiovascular disease in adults.