Department of Paediatric Nephrology, Evelina London Children's Hospital, Guys & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
North Middlesex Hospital, London, UK.
J Hum Hypertens. 2023 Jul;37(7):554-559. doi: 10.1038/s41371-022-00732-7. Epub 2022 Aug 6.
We aimed to describe hypertensive phenotype and demographic characteristics in children and adolescents referred to our paediatric hypertension service. We compared age, ethnicity and BMI in primary hypertension (PH) compared to those with secondary hypertension (SH) and white coat hypertension (WCH). Demographic and anthropometric data were collected for children and adolescents up to age 18 referred to our service for evaluation of suspected hypertension over a 6 year period. Office blood pressure (BP) and out of office BP were performed. Patients were categorised as normotensive (normal office and out of office BP), WCH (abnormal office BP, normal out of office BP), PH (both office and out of office BP abnormal, no underlying cause identified) and SH (both office and out of office BP abnormal, with a secondary cause identified). 548 children and adolescents with mean ± SD age of 10.1 ± 5.8 years and 58.2% girls. Fifty seven percent (n = 314) were hypertensive; of these, 47 (15%), 84 (27%) and 183 (58%) had WCH, PH and SH, respectively. SH presented throughout childhood, whereas PH and WCH peaked in adolescence. Non-White ethnicity was more prevalent within those diagnosed with PH than both the background population and those diagnosed with SH. Higher BMI z-scores were observed in those with PH compared to SH. Hypertensive children <6 years are most likely to have SH and have negligible rates of WCH and PH. PH accounted for 27% of hypertension diagnoses in children and adolescents, with the highest prevalence in adolescence, those of non-White Ethnicity and with excess weight.
我们旨在描述我们儿科高血压门诊就诊的儿童和青少年的高血压表型和人口统计学特征。我们比较了原发性高血压（PH）与继发性高血压（SH）和白大衣高血压（WCH）患者的年龄、种族和 BMI。我们收集了在 6 年期间因疑似高血压就诊于我们的服务的儿童和青少年的人口统计学和人体测量数据。进行了诊室血压（BP）和诊室外血压测量。患者被分类为正常血压（正常诊室和诊室外血压）、WCH（诊室血压异常，诊室外血压正常）、PH（诊室和诊室外血压均异常，未发现潜在原因）和 SH（诊室和诊室外血压均异常，存在继发原因）。共有 548 名儿童和青少年，平均年龄为 10.1±5.8 岁，女孩占 58.2%。57%（n=314）的患者患有高血压；其中，47（15%）、84（27%）和 183（58%）患者分别患有 WCH、PH 和 SH。SH 贯穿整个儿童期，而 PH 和 WCH 在青春期达到高峰。与背景人群和 SH 患者相比，PH 患者中更常见非白种人。与 SH 相比，PH 患者的 BMI z 评分更高。<6 岁的高血压儿童最有可能患有 SH，WCH 和 PH 的发生率可忽略不计。PH 占儿童和青少年高血压诊断的 27%，在青春期、非白种人、超重人群中发病率最高。
