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Characteristics of systemic hypertension in preterm children
Ankur B Shah1, S Sharukh Hashmi, Raj Sahulee
1Division of Pediatric Cardiology, Department of Pediatrics, Children's Memorial Hermann Hospital, University of Texas Medical School, Houston, TX.
Insights
Essential hypertension (EH) is rare in preterm children diagnosed in infancy. However, 46% of preterm children diagnosed later in childhood had EH, indicating distinct risk factors and clinical courses.
Area of Science:
- Pediatric Nephrology
- Neonatology
- Cardiology
Background:
- Essential hypertension (EH) prevalence in preterm children remains unestablished.
- Preterm birth is a risk factor for cardiovascular issues, but hypertension specifics are unclear.
Purpose of the Study:
- To determine the prevalence and characteristics of essential hypertension in preterm children.
- To compare clinical courses and risk factors between infantile and childhood diagnoses of hypertension in premature infants.
Main Methods:
- Retrospective analysis of 36 preterm children diagnosed with hypertension at a tertiary pediatric clinic.
- Categorization into infantile (NICU diagnosis) and childhood diagnosis groups.
- Comparison of gestational age, NICU stay, perinatal factors, and hypertension type.
Main Results:
- Infantile diagnosis group (n=23) had lower gestational age, longer NICU stays, and more perinatal risk factors.
- None in the infantile group had EH; 46% in the childhood group (n=13) had EH.
- 83% of all preterm children had secondary hypertension; EH was diagnosed in 17% and only in those diagnosed beyond infancy.
Conclusions:
- Hypertension in preterm children presents differently based on age at diagnosis, with distinct risk factors and outcomes.
- Essential hypertension is uncommon in preterm children diagnosed in infancy but more prevalent in those diagnosed later in childhood.
Abstract:
The prevalence of essential hypertension (EH) among preterm children is unknown. The authors evaluated consecutive children with a diagnosis of hypertension and prematurity (gestational age <37 weeks) in a tertiary pediatric hypertension clinic and identified 36 preterm hypertensive children. Among these preterm children, 23 were diagnosed in the neonatal intensive care unit (NICU; infantile) and 13 were diagnosed at an older age (childhood). When compared with patients with a childhood diagnosis, patients with an infantile diagnosis had a significantly lower gestational age, longer duration of hospitalization in the NICU, and a higher incidence of perinatal risk factors for hypertension. None with infantile diagnosis had EH, whereas 46% with childhood diagnosis had EH. Among premature children, systemic hypertension was either diagnosed in infancy or in childhood, with each age at diagnosis having unique risk factors and clinical course. Although 83% of preterm children had secondary hypertension, EH was diagnosed in 17% and was only seen in those diagnosed beyond infancy.
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