Profile of a pediatric hypertensive cohort in a tertiary referral center

The overall prevalence of hypertension (HTN) among Israeli Jewish adolescents was reported to be 0.4% in males and 0.074% in females. The demographic characteristics of the Northern Israeli population are unique, with a nearly equal distribution of Arab and Jewish ethnicity. We describe the demographic and clinical characteristics of pediatric hypertensive patients in northern Israel.

Data were retrospectively collected from the electronic medical records (EMRs) of pediatric patients aged 0-18 diagnosed with HTN at Rambam Health Care Campus between 2010-2020. Demographic characteristics, etiology, end-organ damage, and medical treatment data were collected and compared between specific subgroups.

During the study period, 479 children diagnosed with HTN were included. Mean age at diagnosis was 9.6 years. Males made up 64% of the cohort. BMI > 85th percentile was recorded in 45%, and 17% were diagnosed with primary HTN. Primary HTN was more prevalent (32%) in adolescents, the majority of whom were of Jewish ancestry. Obesity prevalence was significantly higher in primary HTN patients. End-organ damage was more common in secondary HTN, subjects of Arab-Muslim origin, consanguinity, and younger age. At follow-up, 35.8% were not on antihypertensive medications. Calcium channel blockers (CCBs) were the most frequently prescribed anti-hypertensives.

Higher rates of secondary HTN than reported in the literature were attributed to high consanguinity and resulted in extensive diagnostic procedures across all age groups, unlike what is recommended by the American Academy of Pediatrics (AAP) guidelines. Better adherence to guideline recommendations was demonstrated in patients referred to the pediatric nephrology institute, highlighting the importance of referring HTN patients to specialized clinics.Key words: Hypertension, Adolescents, Obesity.