ESPN 51th Annual Meeting

ESPN 2018


 
Changing face of hypertension in childhood period
EDA DIDEM KURT-SUKUR 1 ZEYNEP BIRSIN ÖZÇAKAR 1 NILGÜN ÇAKAR 1 ECE MEKIK 1 MESIHA EKIM 1 FATOŞ YALÇINKAYA 1

1- ANKARA UNIVERSITY SCHOOL OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

In contrast to adults, hypertension (HT) in children is usually secondary to an identifiable etiology. However in recent years the obesity epidemic, changes in dietary and daily habits seem to affect the profile of HT in children. The aim of this study was to investigate the causes of newly diagnosed HT in the outpatient and inpatient clinics of a tertiary reference center.

Material and methods:

We retrospectively reviewed the files of patients who were referred to our department with suspected HT during March 2017-March 2018. Patient demographics, clinical and laboratory findings were noted. 

Results:

Among 177 patients, 156 (88%) (96 males; mean age 12.2 ± 4.9 years, R: 1 month-18.7 years) were found to have definite HT and remaining 21 patients had white-coat HT. 108 patients were seen in outpatient and 48 in inpatient clinics. There were eight infants (<12 months), 49 preschoolers / schoolers and 99 adolescents (≥12 years). Stage 1 HT was seen in 102 (65%) and stage 2 in 54 (35%) patients. Essential HT was detected in 104 (67 %) patients; adolescents (76 patients) predominated in this group and majority of the patients were obese or overweight (96 patients). Secondary HT was observed in 52 patients; drugs (56%) and renal causes (31%) were the most common etiologic factors in this group. In the outpatient clinics essential HT (86%) and in the inpatient setting drug related HT (46%) were more frequently encountered. Among adolescents (77%) and preschoolers/ schoolers (57%) essential HT was the primary cause of HT whereas renal causes (63%) predominated in the infantile period. Echocardiography was performed in 110 patients and 20 patients (18%) had left ventricular hypertrophy. 

Conclusions:

Essential HT, especially obesity related HT, became the leading cause of HT in childhood period. Clinicians should give particular importance to this burning public health issue.