[Etiology and blood pressure patterns in secondary hypertension in children]

Abstract

Most studies regarding the etiology of hypertension in children have found a frequency of secondary hypertension 4 to 9 times greater the than in adults (70-90% vs. 10%), with a probability of identifying an underlying disease inversely related with the age and directly related with the severity of hypertension.

Material and method: The purpose of this study is to establish the causes and the patterns of hypertension in a group of 256 children, admitted during a five-year period in the Children's Hospital "Sf. Maria" Iaşi, Romania.

Results: The frequency of secondary hypertension is 4 times greater than essential hypertension. The most frequent causes of secondary hypertension are renal parenchymal disease (83.2%) and cardiovascular disease (coarctation of the aorta) (11.4%); less frequent have been diagnosed neurologic (1%) and endocrinologic diseases (1.5%). Most of the assessed cases (referred to our hospital for different other reasons) have been found with stage 1 and 2 of hypertension right from the moment of admission (88.3%). We established a statistically significant relationship between the severity of hypertension and the secondary type of hypertension, meaning : the higher the blood pressure (BP)--the higher chances of diagnosing an underlying cause of hypertension. Among the secondary causes, the renal or non-renal etiology did not significantly influence the BP values at the moment of admission. Among the different histological types of chronic glomerulonephritis, focal segmental glomerulosclerosis presented with a significant higher BP comparing with the other types.

Conclusion: the frequency of hypertension increased with age: 92.6% of essential hypertension cases belong to age 11-18, 59.2% of renal hypertension cases belong to age 11-18. The exception came from cardiovascular hypertension, which fit into age group 0-6 year old (p < 0.05%). The gender had no significant influence of the etiology of hypertension.