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Prevalence and Risk Factors for Arterial Hypertension Development in Childhood Acute Lymphoblastic Leukemia Survivors
Tomasz Ociepa1, Magdalena Bartnik, Karolina Zielezińska
1Department of Pediatrics, Hemato-Oncology, and Gastroenterology, Pomeranian Medical University, Szczecin, Poland.
Insights
Childhood acute lymphoblastic leukemia (ALL) survivors have a higher risk of arterial hypertension (AH). Regular blood pressure monitoring is recommended for early detection in survivors.
Area of Science:
- Cardiology
- Pediatric Oncology
- Public Health
Background:
- Childhood acute lymphoblastic leukemia (ALL) survivors face increased cardiovascular disease risk, including arterial hypertension (AH).
- Understanding AH prevalence and risk factors in this population is crucial for long-term health management.
Purpose of the Study:
- To determine the prevalence of AH in childhood ALL survivors.
- To characterize AH in survivors.
- To identify risk factors for AH development in childhood ALL survivors.
Main Methods:
- The study included 81 childhood ALL survivors and 52 healthy controls.
- 24-hour ambulatory blood pressure monitoring was conducted on all participants.
- Serum lipids were measured in all participants.
Main Results:
- ALL survivors showed a significantly higher prevalence of AH compared to controls (OR, 2.47; P=0.0315).
- Survivors with AH exhibited higher day-time diastolic SDS and mean arterial pressure SDS.
- AH in survivors was associated with specific blood pressure dipping patterns.
Conclusions:
- Arterial hypertension may affect up to 37% of childhood ALL survivors.
- Early and regular blood pressure monitoring is recommended for childhood ALL survivors.
Background:
Childhood acute lymphoblastic leukemia (ALL) survivors are at an increased risk of cardiovascular disease including arterial hypertension (AH). The objectives of this study were to assess the prevalence of AH using 24-hour ambulatory blood pressure monitoring, explore characteristics of AH, and define risk factors for the development of AH in childhood ALL survivors.
Patients And Methods:
The study comprised 81 childhood ALL survivors (5 to 25 y of age) after a median follow-up time of 5 years. The control group consisted of 52 healthy children (5 to 17 y of age) without any known severe or chronic medical condition. Ambulatory blood pressure monitoring was performed in all patients and controls. Serum lipids were measured in all patients and controls.
Results:
ALL survivors were more likely to have AH than controls (odds ratio, 2.47; 95% confidence interval, 1.08-5.63; P=0.0315). The mean time from ALL diagnosis until diagnosis of AH was 5.1±2.97 years. Day-time diastolic SDS and day-time mean arterial pressure SDS were significantly higher in ALL cohort compared with the controls (-0.3±1.43 vs. -0.76±0.95; P=0.04 and 1.44±1.64 vs. 0.92±1.03; P=0.047). Childhood ALL survivors with AH were more likely to be systolic extreme dippers and reverse systolic/diastolic dippers compared with those with normal blood pressure (P<0.05). There was no association of AH with leukemia subtype, leukemia risk group, sex, central nervous system irradiation, and obesity.
Conclusions:
The prevalence of AH in childhood ALL survivors may be as high as 37%. We recommend regular monitoring of blood pressure in childhood ALL survivors early in the follow-up.
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