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Published on: July 19, 2011
Diminished Blood Pressure Profiles in Children With Down Syndrome
Jonathan D Santoro1,2,3,4, Sarah Lee5, Michael Mlynash5
1From the Department of Neurology, Children's Hospital Los Angeles, CA (J.D.S.).
Insights
Children with Down syndrome (DS) exhibit lower blood pressure trends compared to general pediatric populations. This study found significantly reduced blood pressure percentiles in DS patients, suggesting revised clinical guidelines may be beneficial.
Area of Science:
- Pediatric Cardiology
- Genetics
- Public Health
Background:
- Down syndrome is associated with various health concerns, but cardiovascular profiles require further elucidation.
- Establishing normative blood pressure data for children with Down syndrome is crucial for accurate clinical assessment.
Purpose of the Study:
- To analyze blood pressure trends in a large cohort of children diagnosed with Down syndrome.
- To compare blood pressure percentiles in children with Down syndrome against established national pediatric data.
Main Methods:
- A multicenter, retrospective, cross-sectional study included 887 children (<18 years) with Down syndrome.
- Three blood pressure recordings per patient were analyzed from routine clinic visits.
- Data were compared with National Heart Lung and Blood Institute (NHLBI) and National Health and Nutrition Examination Survey (NHANES) cohorts.
Main Results:
- The average blood pressure percentile for the Down syndrome cohort was 38.87 (median 31.5).
- Blood pressure in children with Down syndrome was statistically lower by 6.1 percentile points compared to NHLBI/NHANES data (P<0.001).
- No patients met criteria for prehypertension or hypertension; only 10% exceeded the 70th percentile.
Conclusions:
- Children with Down syndrome demonstrate a significant reduction in baseline blood pressure compared to age- and height-matched controls.
- These findings suggest a potential need to adjust blood pressure evaluation standards for pediatric patients with Down syndrome.
- This data can inform clinical care and management strategies within pediatric medical homes for individuals with Down syndrome.
Abstract:
This study sought to analyze blood pressure trends in children with Down syndrome at multiple centers. A multicenter, retrospective, cross-sectional study was performed. All patients were <18 years and had a diagnosis of Down syndrome. Existing comorbidities were nonexclusionary. For each patient, 3 blood pressure recordings were obtained from routine clinic visits. In total, 887 patients with 2661 total blood pressure recordings were included in this study. The average blood pressure percentile for patients was 38.87 with a median percentile of 31.5. Age, sex, and race were not predictive of blood pressure percentile. Compared with established data from the National Heart Lung and Blood Institute and National Health and Nutrition Examination Survey cohort (ages 8-18 years), blood pressure in our Down syndrome population was statistically lower by 6.1 percentile points (P<0.001), with the greatest difference at higher blood pressure percentiles (P<0.001). Only 10% of all Down syndrome cohort blood pressure recordings were greater than the National Heart Lung and Blood Institute/National Health and Nutrition Examination Survey 70th percentile, with no patients meeting criteria for prehypertension or hypertension. Additional comparisons against American Academy of Pediatrics data were similar and statistically significant. In children with Down syndrome, there is a 12 percentile point reduction in baseline blood pressure compared with age- and height-matched controls reported in the National Heart Lung and Blood Institute/National Health and Nutrition Examination Survey and American Academy of Pediatrics cohorts. This data can potentially be utilized in the evaluation and care of persons with Down syndrome in their pediatric medical homes.
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