Clinical profi le of adolescents with essential hypertension

Abstract

The prevalence of primary arterial hypertension in children is increasing. Although hypertension in children is mostly asymptomatic, subclinical changes on target organs are already recorded. The aim was to analyze risk factors for arterial hypertension and clinical profi les in adolescents with primary hypertension. Retrospective analysis was performed on 153 children aged 10-18 years (117 M and 36 F) with primary hypertension, hospitalized during a 10-year period. Patients were divided into three groups: prehypertension, stage 1 hypertension and stage 2 hypertension. On statistical analysis, Student’s t-test was used. The level of signifi cance was set at p<0.05. Stage 1 hypertension was found in 27.5%, stage 2 hypertension in 65.4% and prehypertension in 7.1% of study patients. The majority of children (89.8%) had a positive family history of hypertension. Body mass index above the 95th percentile was recorded in 41.2% of patients, above 30 kg/m2 in 18.9% of them; children with stage 2 hypertension were more obese than children with stage 1 hypertension (p=0.005). In both hypertensive groups, the unfavorable form of non decreasing pressure (non dipper) was more frequent. Left ventricular hypertrophy was present in 15% of patients. Laboratory results (blood glucose, urate, total cholesterol and triglycerides) did not diff er statistically signifi cantly between the two hypertensive groups. Hepatic steatosis was found in 5.9% and hypertensive retinal abnormalities in 1.6% of patients, both in the stage 2 hypertension group. Antihypertensive therapy, mostly angiotensin-converting enzyme inhibitors, was initiated in 20.3% of patients. In conclusion, a signifi cant number of adolescents with primary hypertension are adipose and have a positive family history of hypertension. Prevention of hypertension should begin in childhood.