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Clinical characteristics of pediatric hypertension: a multicenter study in China
Yijun Chen1,2, Peiyu Ye1, Hongbo Dong1
1Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing.
Insights
Secondary hypertension is the most common type of pediatric hypertension in China, increasing over the past decade. Obesity and related conditions are prevalent in primary hypertension cases among children.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Public Health
Background:
- Pediatric hypertension is a growing concern with limited clinical data on its characteristics and trends.
- Understanding these trends is crucial for effective public health strategies and clinical management.
Purpose of the Study:
- To investigate the clinical characteristics of pediatric hypertension in hospitalized children in China.
- To analyze the secular trends of different hypertension types in this population over a decade.
Main Methods:
- Retrospective analysis of medical records from 5847 pediatric inpatients diagnosed with hypertension.
- Data collected from nine tertiary children's hospitals in China between 2010 and 2020.
- Analysis focused on clinical characteristics from first admission records.
Main Results:
- Secondary hypertension remained the dominant type, increasing from 51.2% (2010-2015) to 59.8% (2016-2020).
- Neurologic disorders were primary causes in younger children (<3 years), shifting to renal diseases in older children.
- Secondary hypertension was more prevalent in girls and children under five. Over 85% of primary hypertension cases involved obesity and comorbidities, a rising trend.
Conclusions:
- Secondary hypertension is increasingly prevalent in Chinese children, particularly girls, with renal diseases as a major cause.
- Obesity and associated comorbidities are significant factors in pediatric primary hypertension, with a concerning upward trend.
- These findings highlight the need for targeted interventions and further research into pediatric hypertension management.
Objectives:
Hypertension in children has attracted increasing attention. However, clinical-based studies investigating characteristics and secular trends of pediatric hypertension remain limited. This study aimed to investigate the clinical characteristics and secular trends of different types of hypertension among hospitalized children in China.
Methods:
This retrospective analysis was based on medical records from nine tertiary children's hospitals in China during 2010∼2020. A total of 5847 pediatric inpatients (aged <18 years) with the diagnosis of hypertension were enrolled. Information on the clinical characteristics of each patient was obtained from their first admission records.
Results:
During the past decade, secondary hypertension sustained to be the dominant type of hypertension in children, with the proportion increased from 51.2% during 2010∼2015 to 59.8% during 2016∼2020. The main causes of secondary hypertension were neurologic disorders in children aged 0∼2 years, which changed to renal diseases after 3 years of age. Compared with primary hypertension, secondary hypertension was common in girls (43.1 vs. 23.3%) and children under 5 years of age (32.2 vs. 2.1%). Moreover, over four-fifths of primary hypertensive individuals had obesity and obesity-related comorbidities, and the proportion of clusters of one or more comorbidities increased in the past decade (79.7 → 85.2%).
Conclusion:
Secondary hypertension sustained to be the dominant type of hypertension among children, especially in girls. Renal diseases were the most common causes of secondary hypertension in children, followed by rheumatic immune diseases. For primary hypertension, over four-fifths of inpatients had obesity and obesity-related diseases, and the proportion kept rising.
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