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Hypertension in Jordanian children: a retrospective analysis of 70 cases
Insights
Pediatric hypertension is predominantly secondary to kidney issues in Jordan. Renal parenchymal diseases caused most cases, with surgical cures possible for some secondary hypertension causes.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Research
- Public Health
Background:
- High blood pressure (hypertension) in children and adolescents is a growing concern.
- Identifying the causes of hypertension in young patients is crucial for effective management.
- Jordan University Hospital observed a significant number of pediatric hypertension cases over three years.
Purpose of the Study:
- To investigate the prevalence and etiologies of hypertension in pediatric patients at Jordan University Hospital.
- To differentiate between essential and secondary hypertension in this age group.
- To analyze the specific causes of secondary hypertension, particularly renal-related conditions.
Main Methods:
- Retrospective review of 70 pediatric patients (aged 1-20 years) diagnosed with hypertension.
- Analysis of blood pressure (BP) readings, ranging from 140-230 mmHg systolic and 90-130 mmHg diastolic.
- Categorization of hypertension causes, including essential hypertension, renal parenchymal diseases (RPD), reno-vascular lesions, renal transplantation, teenage pregnancy, and phaeochromocytoma.
Main Results:
- Secondary hypertension accounted for 91.4% of cases (n=64), with essential hypertension in only 8.6% (n=6).
- Renal parenchymal diseases (RPD) were the leading cause of secondary hypertension (65.7%, n=46).
- Specific RPD causes included end-stage renal disease (14), acute glomerulonephritis (14), idiopathic nephrotic syndrome (10), chronic renal insufficiency (5), and polycystic kidney disease (3). Reno-vascular lesions (11.4%), renal transplantation (7.2%), teenage pregnancy (5.7%), and phaeochromocytoma (1.4%) were other causes.
Conclusions:
- The vast majority of pediatric hypertension cases in this Jordanian cohort are secondary, primarily driven by renal parenchymal diseases.
- Early diagnosis and management of underlying renal conditions are critical for controlling hypertension in children.
- Surgical intervention offered a cure for hypertension in patients with reno-vascular lesions and phaeochromocytoma, highlighting the importance of identifying treatable secondary causes.
Abstract:
Seventy patients, aged 1-20 years, were seen at Jordan University Hospital with high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230 mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure. Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension (n = 64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%), teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in 14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10, chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical cure of hypertension was achieved in 5 of the children with reno-vascular lesions and in the patient with phaeochromocytoma.