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Published on: August 1, 2018
Characteristics of pediatric inpatients with primary and secondary hypertension
Yijun Chen1, Peiyu Ye1, Xiaorong Liu2
1Department of Non-communicable Disease Management Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
Insights
Secondary hypertension is more common in pediatric hospital patients than primary hypertension. Renal diseases are the most frequent cause of secondary hypertension in children, impacting younger patients with lower BMIs.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Research
- Clinical Pediatrics
Background:
- Hypertension (HTN) prevalence in children is well-studied, but data on specific types and causes of secondary HTN are limited.
- Understanding pediatric HTN characteristics is crucial for effective diagnosis and management.
Purpose of the Study:
- To investigate the characteristics of different pediatric hypertension types.
- To identify the primary causes of secondary hypertension in a pediatric hospital setting.
Main Methods:
- Retrospective analysis of 1470 pediatric inpatients (<18 years) diagnosed with HTN (2015-2020).
- Patients classified into primary and secondary HTN groups based on medical records.
- Statistical analysis (Mann-Whitney U, Chi-squared, Fisher's exact tests) used to compare groups.
Main Results:
- Secondary HTN (68.8%) was more prevalent than primary HTN (31.2%) in pediatric inpatients.
- Secondary HTN patients were younger, had lower BMIs, and longer hospital stays.
- Renal diseases caused 46.3% of secondary HTN; primary HTN was often linked to obesity and managed by Endocrinology/Cardiology.
Conclusions:
- Secondary hypertension is the predominant form of HTN in pediatric hospital settings.
- Renal disease is the leading etiology for secondary hypertension in children.
- Distinct clinical profiles exist for primary versus secondary pediatric hypertension.
Importance:
Extensive population-based studies have explored the prevalence of primary hypertension (HTN) in children and adolescents. However, there is little published data on the characteristics of different types of pediatric HTN and the causes of secondary HTN.
Objective:
To investigate the characteristics of different types of pediatric HTN and the causes of secondary HTN in a hospital setting.
Methods:
The study cohort comprised pediatric inpatients (<18 years of age) discharged with a diagnosis of HTN from Beijing Children's Hospital during 2015-2020. Pediatric patients with HTN were allocated to secondary and primary HTN groups on the basis of comprehensive analyses of their diagnoses, family history of HTN, and findings on physical examination, as documented in their medical records. The Mann-Whitney U test, χ 2 and Fisher's exact test were used to assess differences in characteristics of patients with different HTN types and causes of secondary HTN.
Results:
Data of 1470 inpatients with HTN from 18 clinical departments were included in the analysis. Among them, 458 (31.2%) had primary HTN, and 1012 (68.8%) had secondary HTN. Compared with patients had primary HTN, children with secondary HTN were younger and had lower body mass indexes and longer lengths of stay. Moreover, children with primary HTN had mostly been managed by the Endocrinology and Cardiology Departments, 75.8% of them having obesity-related comorbidities. In contrast, most patients with secondary HTN had been managed by the Nephrology Department, renal diseases being the leading cause of their HTN (46.3%).
Interpretation:
Secondary HTN is more common than primary HTN in pediatric clinical settings, renal diseases being the leading cause of secondary HTN.
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