Exarchakis Alyssa, Cohen Alexandra, Wang Penghao, Rani Seema, Martinez Diana
Department of Biomedical Sciences, Cooper Medical School, Rowan University, 401 South Broadway, Camden, NJ 08103, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
J Clin Med. 2025 Jul 3;14(13):4699. doi: 10.3390/jcm14134699.
: The relationship between OSA and adult hypertension has been extensively studied; however, it remains understudied in pediatric patients without OSA. The aim of this study is to identify factors associated with pediatric hypertension without OSA, through an IRB-approved retrospective chart review of patients who underwent polysomnography at Nemours Children's Hospital, DE/NJ between January 2020 and July 2023. : Eligibility criteria included children 8-17 years, completed PSG, and clinic visit blood pressure (BP). Anthropometrics, demographics, social determinants, and medical history were obtained from electronic medical records. Hypertension was defined as the average systolic and/or diastolic BP that is ≥95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. All variables were checked for normality. Chi-square tests for categorical data and Wilcoxon rank sum tests for continuous data were used to test significance between non-OSA non-hypertensives (NH) and hypertensives (H). < 0.05 is considered significant. Of 285 charts evaluated, 137 were classified as non-OSA. Patient information, including parents in household, smoking exposure, and food allergies, were statistically significant ( < 0.05) in hypertensive pediatric patients without OSA. Hypertension was significantly correlated ( < 0.05) with birth weight, BMI, daytime heart rate, systolic BP, and diastolic BP. Statistically significant differences ( < 0.05) were found in mental illnesses, neurological disease, and respiratory disease. Among polysomnography parameters, only nighttime heart rate was found to be statistically significant. The data suggests that in pediatric patients without OSA, there are multiple factors and co-morbidities associated with hypertension. These factors and co-morbidities warrant additional follow up in clinical practice to mitigate the risks of hypertension in pediatric patients.
阻塞性睡眠呼吸暂停（OSA）与成人高血压之间的关系已得到广泛研究；然而，在没有OSA的儿科患者中，这方面的研究仍较少。本研究的目的是，通过对2020年1月至2023年7月期间在特拉华州/新泽西州内穆尔儿童医院接受多导睡眠图检查的患者进行一项经机构审查委员会批准的回顾性病历审查，来确定与无OSA的儿童高血压相关的因素。入选标准包括8至17岁的儿童、完成多导睡眠图检查以及门诊就诊时的血压（BP）。人体测量学、人口统计学、社会决定因素和病史均从电子病历中获取。根据美国儿科学会临床实践指南，高血压定义为基于性别、年龄和身高的平均收缩压和/或舒张压≥第95百分位数。对所有变量进行正态性检验。使用分类数据的卡方检验和连续数据的威尔科克森秩和检验来检验非OSA非高血压患者（NH）和高血压患者（H）之间的显著性。P < 0.05被认为具有显著性。在评估的285份病历中，137份被归类为非OSA。在没有OSA的高血压儿科患者中，患者信息，包括家庭中的父母、吸烟暴露和食物过敏，具有统计学显著性（P < 0.05）。高血压与出生体重、体重指数、日间心率、收缩压和舒张压显著相关（P < 0.05）。在精神疾病、神经疾病和呼吸系统疾病方面发现了统计学显著性差异（P < 0.05）。在多导睡眠图参数中，仅夜间心率具有统计学显著性。数据表明，在没有OSA的儿科患者中，有多种因素和合并症与高血压相关。这些因素和合并症值得在临床实践中进行进一步随访，以降低儿科患者患高血压的风险。
