Retrospective analysis of etiology and target organ damage in children with hypertension
ZHANG Mingming, SHI Lin, LI Xiaohui, WANG Li,LIU Yang, LIN Yao,CONG Xiaohui,and QI Tiexiong
ZHANG Mingming, SHI Lin, LI Xiaohui, WANG Li,LIU Yang, LIN Yao,CONG Xiaohui,and QI Tiexiong. Department of Pediatric Cardiology, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
Abstract：Objective To analyze the clinical data of children with primary hypertension and secondary hypertension in order to provide reference for accurate diagnosis and for early detection of target organ damage in case of primary hypertension.Methods All the children who were diagnosed with hypertension and hospitalized between January 1992 and May 2016 were enrolled in this study. Hypertension was classified as primary and secondary based on the etiology of hypertension. Data was analyzed with SPSS 17.0 software.Results (1)The average age of primary hypertension patients was 11.76 years old, and the mean BMI was 26.90 kg/m2, which were higher than those of secondary hypertension patients with statistically significant difference (P=0.000). (2)The composition ratio of secondary hypertension during infancy, preschool period, school age and adolescence was 94.7%、48.3%、17.0% and 8.6% respectively. Adolescents were more vulnerable to primary hypertension than children of other ages. (3) 59.42% of secondary hypertension patients had kidney disease. Blood pressure was higher in secondary hypertension patients.(4) Target organ damage was present during diagnosis in most of the patients with primary hypertension. Elevated levels of serum or urine β2-microglobulin could be an earlier indicator of kidney damage. In the target organ damage group, the mean diastolic blood pressure and insulin level were higher.Conclusions Patients with secondary hypertension were younger than patients with primary hypertension, and blood pressure was higher. The causes of secondary hypertension are mainly kidney and vascular lesions. Target organ damage can be detected during diagnosis in most of the patients with primary hypertension. The higher diastolic blood pressure and insulin levels, the more likely target organ damage can be.
张明明, 石琳, 李晓惠, 王琍, 刘杨, 林瑶, 丛晓辉, 齐铁雄. 高血压患儿病因及其靶器官损害相关因素分析[J]. 武警医学, 2017, 28(8): 780-783.
ZHANG Mingming, SHI Lin, LI Xiaohui, WANG Li,LIU Yang, LIN Yao,CONG Xiaohui,and QI Tiexiong. Retrospective analysis of etiology and target organ damage in children with hypertension. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(8): 780-783.
National H,Lung E, Blood I. Report of the Task Force on Blood Pressure Control in children-1987[J].Pediatrics,1987,79(1):1-25.
[3]
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents.The fourth report on the diagnosis,evaluation,and treatment of high blood pressure in children and adolescents[J].Pediatrics,2004,114(2 Suppl 4th Report):555-576.
[4]
Hietalampi H, Pahkala K, Jokinen E, et al. Left ventricular mass and geometry in adolescence: early childhood determinants[J]. Hypertension,2012,60(5):1266-1272.
[5]
Monesha G M, Ashish B, Sanjay S, et al. Essential hypertension VS. secondary hypertension among children[J]. Am J Hypertens,2015,28(1): 73-80.
[6]
孟玲慧.儿童青少年高血压及其危险因素对早期靶器官损害的影响[D].北京:北京协和医学院,2012.
[7]
Juhola J, Magnussen C G, Berenson G S, et al. Combined effects of child and adult elevated blood pressure on subclinical atherosclerosis: the international childhood cardiovascular cohort consortium[J]. Circulation,2013,128(3):217-224.
Zhou M S,Schulman I H,Raij L. Vascular inflammation,insulin resistance,and endothelial dysfunction in salt-sensitive hypertension:role of nuclear factor kappa B activation[J].J Hypertens,2010,28(3):527-535.
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