ANALYZE THE CAUSES OF HYPERTENSION AMONG YOUNG CHILDREN AND ITS COMPREHENSIVE CLINICAL CORRELATION AT TEACHING HOSPITAL, TURBAT
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Keywords
Hypertension, Acute glomerulonephritis, chronic kidney disease, seizures
Abstract
Objective: To find out the etiology and presenting features of hypertension in children came to pediatric department, teaching hospital, Turbat.
Materials and Methods: A cross-sectional study conducted at the teaching hospital, turbat with a total period of six months from July, 2023 to Jan, 2024. The study participants included 90 children from 1 to 15 years of age, with diagnosed case of hypertension having 95 percentiles for age, sex and height. Patient information was recorded on the proforma including age, sex, weight, systolic BP, diastolic BP, presenting complaints (including headache, decrease sensorium, seizures, pallor, congestive cardiac failure, vomiting), the investigations (Hb, urea, creatinine) and finally diagnosis. The data was analyzed by using SPSS version 21.
Results: Out of 90 children included in this study, there were 54 (60%) males and 36 (40%) females. Mean age was 8 ± 2.32 years while most (90%) of the patients were above 5 years’ age. Mean systolic BP was 145.24 ± 17.02 mm Hg and mean diastolic BP was 98.84 ± 14.57 mm Hg. The most common diagnosis was acute glomerulonephritis (AGN) in 52.2% followed by 32.2% of chronic kidney disease (CKD), 7.7% of pyelonephritis, 6.6% of nephrotic syndrome and remaining 1.1% of Wilm’s tumor. The most common clinical feature was seizures in 38.8% and headache 32.2% patients. Seizures were significantly noticed in 20 out of 47 (44.8%) AGN patients and 13 out of 29 (42.5%) CKD patients. Regarding headache, the highest frequency was noticed 5 out of 6 (83.3%) in nephrotic syndrome while 17 out of 47 (36.1%) in AKG patients.
Conclusion: Renal disease is the most common cause of hypertension in children at turbat region, and the majority of patients presented with headache and seizures as the signs of high blood pressure.
References
2. Mancia Chairperson G, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, Tsioufis K, Agabiti-Rosei E, Eae A, Azizi M, Benetos A. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). Journal of hypertension. 2023;41(12):1874-2071.
3. Price JJ, Urbina EM, Carlin K, Becker R, Daniels SR, Falkner BE, Ferguson M, Hanevold C, Hooper SR, Ingelfinger JR, Lande MB. Cardiovascular risk factors and target organ damage in adolescents: the SHIP AHOY study. Pediatrics. 2022 Jun 1;149(6):e2021054201..
4. Koebnick C, Black MH, Wu J, Martinez MP, Smith N, Kuizon BD, et al. The prevalence of primary pediatric prehypertension and hypertension in a real-world managed care system. J Clin Hypertens (Greenwich) 2013;15(11): 784–92.
5. Hegde S, Ahmed I, Aeddula NR. Secondary hypertension.(2019)
6. Kaelber DC, Liu W, Ross M, Localio AR, Leon JB, Pace WD, Wasserman RC, Fiks AG. Diagnosis and medication treatment of pediatric hypertension: a retrospective cohort study. Pediatrics. 2016 Dec 1;138(6).
7. Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniels SR. Systolic Blood Pressure in Childhood Predicts Hypertension and Metabolic Syndrome Later in Life. Pediatrics 2007; 119, 237–246.
8. Wójcik M, Kozioł-Kozakowska A, Obesity. Sodium Homeostasis, and arterial hypertension in children and adolescents. Volume 13. Nutrients; 2021. p. 4032.
9. Samuels JA, Zavala AS, Kinney JM, Bell CS. Hypertension in Children and Adolescents. Advances in Chronic Kidney Disease 2019: 26(2):146-50.
10. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997; 126(5):376–380. https://doi.org/10.7326/0003-4819-126-5-199703010-00006 PMID: 9054282
11. Saini P, Betcherman L, Radhakrishnan S, Etoom Y. Paediatric hypertension for the primary care provider: What you need to know. Paediatric Child Health 2020; pxaa069 https://doi.org/ 10.1093/ pch/pxaa069.
12. Aleksandrov AA, Kisliak OA, Leontyeva IV. Clinical guidelines on arterial hypertension diagnosis, treatment and prevention in children and adolescents. Systemic Hypertension 2020;17(2): 7-35.
13. Katerina C, Athanasia C, Vasiliki K, John D, Nikoleta P, Stella S. Secondary Hypertension in Children and Adolescents: Novel Insights. Current Hypertension Reviews 2020;16(1):37-44.
14. Kaplinski M, Griffis H, Liu F, Tinker C, Laney NC, Mendoza M. Clinical Innovation: A Multidisciplinary Program for the Diagnosis and Treatment of Systemic Hypertension in Children and Adolescents. Clin Pediatr 2020;59(3):228-235.
15. Litwin M, Feber J. Origins of Primary Hypertension in Children. Early Vascular or Biological Aging? Hypertension 2020;76:1400–09. https://doi.org/10.1161/hypertensionaha.120. 14586.
16. Hari P, Bagga A, Srivastava RN. Sustained hypertension in children. Ind Pediatr 2000; 37(3):268-74.
17. Mohammed A, Balachandra S, Tunnel K. Etiology of Hypertension and its Association with Obesity in the Pediatric Population. Pediatr 2020;146:74.
18. Ugwu GI, Nwajei G, Chinemelu U. Pattern of Renal Diseases among Children in The Niger Delta Region, Nigeria. Arab J Nephrol Transplant 2014;7:49-50.
19. Sathiadas MG, Archchana A, Niroshan V. Clinical profile of children with renal disease admitted to a tertiary care centre in Sri Lanka.
20. Kumar M, Kumari R, Thakur KC, Tomar A, Batra G, Bose P, Bhuddi S, Bangri A. Retrospective audit of a pediatric nephrology clinic at a tertiary care teaching hospital. Journal of Pediatric Nephrology. 2021 Jan 1;9(2).
21. Malhotra MG, Banker A, Shete S, Hashmi SS, Tyson JE, Barratt MS, et al. Essential Hypertension vs. Secondary Hypertension among Children. Am J Hypertens 2015;28(1):73-80.
22. Komur M, Ozgur A, Delibas A, Bozlu G, Alakaya M, Direk M, et al. Posterior reversible encephalopathy syndrome (PRES) due to acute hypertension in children: 12 years single-center experience. Acta Neurologica Belgica 2020.
23. Bhatti N, Krishin J, Azam M, Khan MA, Alam S. Etiology of systemic Hypertension in children. J Pak Inst Med Sci 2002;13(1):635-40.
24. Batouche DD, Kerboua KE, Sadaoui L, Benhamed F, Zohret-Bouhalouane S, Boucherit N, et al. Profil clinique et étiologique de l'hypertensionar- tériellemaligne chez l'enfantenréanimation- pédiatrique [Clinical and etiological profile malignant hypertension in children in pediatric intensive care]. Ann Cardiol Angeiol (Paris) 2016;65(3):165-70.
25. Bhookya SK, Shireesha A, Allakonda PK, Tikka NK. A PROSPECTIVE STUDY OF AETIOLOGICAL AND CLINICAL PROFILE OF HYPERTENSION IN CHILDREN. Hypertension. 2022 Dec.
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Muhammad Wasif Saleem
Assistant Professor, Department of Pathology, Mekran Medical College, Turbat, Pakistan.
Tayyab Uddin Khand
Assistant Professor, Department of Biochemistry, Mekran Medical College, Turbat, Pakistan.
Abdul Samad Gichki
Associate Professor, Department of Oral Medicine, Bolan Medical College, Khuzdar, Pakistan.
Mohammad Afzal Khaliq
Assistant Professor, Department of ENT, Mekran Medical College, Turbat, Pakistan.
Shazia Hashmat
Associate Professor, Department of Physiology, Ziauddin Medical College, Pakistan.
Sadaf Fatima
Professor, Department of Physiology, Sohail University, Pakistan.