-Original-

Hypertension in 172 Chinese Children: An 8-Year Retrospective Study

Di Cao¹, Yewei Chen², Xuan Gao², Yiqing Zhu², Dan Wu² and Gongbao Liu¹

¹Medical Affairs Department, Children's Hospital of Fudan University, Shanghai, China
²Department of Pharmacy, Children's Hospital of Fudan University, Shanghai, China

Background: We evaluated children with hypertension and compared those with essential and secondary (including renal and non-renal) hypertension.
Methods: This retrospective study analyzed data from hypertensive children (age, 0-18 years) referred for treatment between January 2008 and December 2015. Demographic factors, causative factors, and medical treatments were evaluated. Treatment failure was defined as a systolic or diastolic blood pressure ≥95th percentile for age, gender, and height on three separate occasions, despite treatment. All patients not meeting the failure criteria were considered to have controlled hypertension. The control rate was defined as the proportion of patients with controlled blood pressure.
Results: Among 172 consecutive patients, 28% had essential hypertension and 72% had secondary hypertension. As compared with children with secondary hypertension, those with essential hypertension had a higher frequency of family history of hypertension (P<0.001), a higher body mass index (BMI) (P=0.001), lower frequency of proteinuria (P=0.003), lower uric acid (P=0.04), and lower triglyceride (P=0.048). The medications used in the controlled group were similar to those used in the uncontrolled group. Angiotensin-converting enzyme inhibitors (ACEIs) were only used in nephrogenic patients, and a higher rate of ACEI use seemed to increase control rates. Control rates did not significantly differ by age, number of drugs, or cause of hypertension.
Conclusions: As compared with children with secondary hypertension, those with essential hypertension were more likely to have a family history of hypertension and had a higher BMI, lower frequency of proteinuria, and lower uric acid and triglyceride concentrations. Treatment guidelines for essential and secondary hypertension should be established for children of all ages.

J Nippon Med Sch 2021; 88: 178-188

Keywords
hypertension, essential, hypertension, secondary, children, etiology, medication

Correspondence to
Gongbao Liu, Medical Affairs Department, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, China
18017591115@163.com

Received, September 16, 2019
Accepted, April 20, 2020