Hussain Junayd, Ahmed Rabeeyah, Robinson Cal H, Jeyakumar Nivethika, Smith Graham, Brady Tammy M, Dart Allison B, Dionne Janis, Karam Sabine, McKay Ashlene, Parekh Rulan S, Sinha Manish D, South Andrew M, Vincent Carol, Chanchlani Rahul
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Lancet Reg Health Am. 2025 Jun 24;48:101157. doi: 10.1016/j.lana.2025.101157. eCollection 2025 Aug.
The global prevalence of paediatric hypertension has increased, contributing to long-term cardiovascular and kidney morbidity. However, healthcare resource utilisation and costs attributable to paediatric hypertension remain uncertain. This study evaluates healthcare utilisation and costs among hypertensive children compared to controls.
In a population-based retrospective cohort study, we analysed youth (aged 3-18 years) diagnosed with hypertension in Ontario, Canada (1993-2021). Using propensity score matching, 25,605 hypertensive children were compared to 128,025 controls and followed until death, emigration, or 31 March 2022. Healthcare utilisation (hospitalisations, emergency visits, outpatient visits) was assessed via negative binomial regression. Secondary outcomes included healthcare costs and specialist follow-up.
Median age was 15 years [IQR 11-17], 49% were female, and comorbidities were uncommon (4% (6497/153,630) congenital heart disease, 2% (9359/153,630) malignancy, 2% (2892/153,630) diabetes, 1% (2004/153,630) chronic kidney disease). Over a median follow-up of 12.9 [IQR 6.8-19.9] years, hypertensive children had higher hospitalisations (rate ratio [RR] 2.13, 95% CI 2.03-2.22), emergency visits (RR 1.08, 95% CI 1.05-1.11), and outpatient visits (RR 1.33, 95% CI 1.31-1.34). Mean healthcare costs were substantially higher in children with hypertension, especially in the first year ($16,690 vs $2659 per person-year).
Healthcare resource utilisation was significantly higher in youth with hypertension. These findings provide a basis for future cost-effectiveness studies on preventing paediatric hypertension and its complications.
This study was funded in part by a 2021/2022 CoRE Builder Team Grant from McMaster University's Department of Paediatrics and supported by ICES Western, funded by the Ontario Ministry of Health (MOH) and Ministry of Long-Term Care.
全球儿童高血压患病率呈上升趋势，这会导致长期的心血管和肾脏疾病。然而，儿童高血压的医疗资源利用情况和相关成本仍不明确。本研究评估了高血压儿童与对照组儿童的医疗利用情况和成本。
在一项基于人群的回顾性队列研究中，我们分析了加拿大安大略省（1993 - 2021年）诊断为高血压的青少年（3 - 18岁）。采用倾向得分匹配法，将25,605名高血压儿童与128,025名对照儿童进行比较，并随访至死亡、移民或2022年3月31日。通过负二项回归评估医疗利用情况（住院、急诊就诊、门诊就诊）。次要结局包括医疗成本和专科随访。
中位年龄为15岁[四分位间距11 - 17岁]，49%为女性，合并症不常见（4%（6497/153,630）患有先天性心脏病，2%（9359/153,630）患有恶性肿瘤，2%（2892/153,630）患有糖尿病，1%（2004/153,630）患有慢性肾脏病）。在中位随访12.9年[四分位间距6.8 - 19.9年]期间，高血压儿童的住院率更高（率比[RR] 2.13，95%置信区间2.03 - 2.22）、急诊就诊率更高（RR 1.08，95%置信区间1.05 - 1.11）以及门诊就诊率更高（RR 1.33，95%置信区间1.31 - 1.34）。高血压儿童的平均医疗成本显著更高，尤其是在第一年（每人每年16,690美元对2659美元）。
高血压青少年的医疗资源利用显著更高。这些发现为未来关于预防儿童高血压及其并发症的成本效益研究提供了依据。
本研究部分由麦克马斯特大学儿科学系2021/2022年核心建设团队资助，并得到由安大略省卫生部（MOH）和长期护理部资助的ICES西部的支持。
