Etiology and Medication of Hospitalized Children With Hypertension: A Retrospective Study
Chenhong Jia1, Weijing Ding1, Xiangyu Ding1
1Department of Pharmacy, Hebei Children's Hospital, Shijiazhuang, Hebei Province, China.
Insights
Pediatric hypertension is rising, with renal and drug-induced causes common. Nifedipine is frequently used, but further research is needed to ensure effective treatment and prevent organ damage in children.
Area of Science:
- Pediatrics
- Cardiology
- Pharmacology
Background:
- Increasing incidence of pediatric hypertension necessitates better treatment guidelines.
- Limited high-quality data on antihypertensive drugs in children hinders optimal clinical practice.
- This study addresses the need for evidence-based pediatric hypertension management.
Purpose of the Study:
- To analyze clinical data of hospitalized pediatric patients with hypertension.
- To identify common causes and prescribed antihypertensive medications.
- To evaluate treatment outcomes and identify organ damage in pediatric hypertension.
Main Methods:
- Retrospective analysis of clinical data from 203 hospitalized pediatric patients over 3 years.
- Inclusion criteria: diagnosis of hypertension and treatment with antihypertensive drugs.
- Data collected on patient demographics, hypertension causes, medications, blood pressure normalization, and organ damage.
Main Results:
- Hypertension observed in 65% of pediatric patients; primary and secondary causes identified.
- Renal (35%) and drug-induced (19.2%) factors were leading causes of secondary hypertension.
- Nifedipine (67.5%) and captopril (41.4%) were most prescribed; 54.7% achieved normal blood pressure; 23.2% showed organ damage.
Conclusions:
- Timely diagnosis and treatment are crucial for preventing organ damage in pediatric hypertension.
- While nifedipine is common, its long-term appropriateness in children requires further investigation.
- Close monitoring of target organs and thorough post-discharge follow-up are essential for pediatric hypertension management.
Abstract:
With the increasing incidence of hypertension in children, the lack of high-quality research data on antihypertensive drugs in pediatric patients restricts treatment options for clinicians and can lead to suboptimal outcomes. We conducted a retrospective analysis of clinical data from hospitalized pediatric patients diagnosed with hypertension and treated with antihypertensive drugs in the past 3 years. The study included 203 pediatric patients (119 males and 84 females), with an average age of 8.9 ± 4.7 years (range: 0.1-17 years). Clinical symptoms of hypertension were observed in 132 participants (65.0%), and the conditions in all cases were classified as primary or secondary hypertension. Renal causes (71 patients, 35.0%) and drug-induced factors (39 patients, 19.2%) were the main causes of secondary hypertension. Nifedipine (137 patients, 67.5%) was the most commonly prescribed medication, followed by captopril (84 patients, 41.4%). Multiple antihypertensive medications were prescribed to 99 participants (48.8%), and blood pressure returned to normal in 111 patients (54.7%). Hypertension-related organ damage was observed in 47 patients (23.2%). Timely diagnosis and treatment of hypertension are critical to prevent organ damage in pediatric patients. Although nifedipine was widely used in this pediatric cohort, the appropriateness of this treatment remains unclear. Emphasis should be placed on monitoring target organs affected by pediatric hypertension, and post-discharge antihypertensive treatment should include thorough follow-ups and documentation.
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