Grisaru Silviu, Yue Melissa W, Mah Justin C, Hamiwka Lorraine A
Alberta Children's Hospital, Division of Paediatric Nephrology, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, Canada.
Int J Hypertens. 2013;2013:419208. doi: 10.1155/2013/419208. Epub 2013 Jul 22.
Childhood hypertension's increasing prevalence has generally been linked to the obesity epidemic. We observed that a significant proportion of children referred to our pediatric center with documented office hypertension are nonobese and have a history of attention deficit hyperactivity disorder (ADHD). To define the extent of this anecdotal observation, we performed a retrospective analysis of ambulatory blood pressure monitoring (ABPM) tests which in our center are routinely performed in newly referred children suspected of hypertension. Twenty-one percent (48 of 227 new referrals) had a history of ADHD, and 81% of them were treated with psychostimulant medications at the time of their ABPM test. Children in this group had a significantly lower average BMI z-score compared with the rest of the children (0.18 versus 0.75) and were significantly more likely to have abnormally elevated wake systolic loads on ABPM (38% versus 4%). The overall proportion of children with any abnormality on ABPM was comparable in both groups (46% versus 40%). Conclusion. A significant proportion of children suspected of hypertension have ADHD which may be related to higher wake systolic BP values. The prevalence of hypertension among children with ADHD will have to be determined in prospective studies.
儿童高血压患病率的上升通常与肥胖流行有关。我们观察到，在我们儿科中心因诊室高血压记录而转诊的儿童中，有很大一部分并非肥胖，且有注意力缺陷多动障碍（ADHD）病史。为了确定这一轶事性观察的程度，我们对动态血压监测（ABPM）测试进行了回顾性分析，在我们中心，ABPM测试是对新转诊的疑似高血压儿童常规进行的。21%（227名新转诊儿童中的48名）有ADHD病史，其中81%在进行ABPM测试时正在接受精神刺激药物治疗。与其他儿童相比，该组儿童的平均BMI z评分显著更低（分别为0.18和0.75），并且在ABPM时出现异常升高的清醒收缩压负荷的可能性显著更高（分别为38%和4%）。两组中ABPM有任何异常的儿童总体比例相当（分别为46%和40%）。结论。很大一部分疑似高血压的儿童患有ADHD这可能与较高的清醒收缩压值有关。ADHD儿童中的高血压患病率有待前瞻性研究确定。
