ESPN 53rd Annual Meeting

ESPN 2021


 
Demographic characteristics of childhood hypertension in the United Kingdom
EMILY HASELER 2 CHEENTAN SINGH 3 JOANNA NEWTON 1 NABIL MELHEM 1 MANISH D SINHA 1

1- EVELINA LONDON CHILDRENS HOSPITAL, LONDON, UNITED KINGDOM
2- UNIVERSITY HOSPITAL LEWISHAM, LONDON, UNITED KINGDOM
3- NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST, LONDON, UNITED KINGDOM
 
Introduction:

 

We report on demographic characteristics in Children and Young People (C&YP) from the largest dedicated paediatric hypertension clinic in the UK.

 

Material and methods:

Prospective data including all C&YP over a recent 6 year period (2013-2018). Patients categorised as normotensive, white coat hypertension (WCH), primary hypertension (PH) and secondary hypertension (SH) and compared across age groups <6 (n=162), 6 to <12 (n=114), and 12 to <18 years (n=272).

 

Results:

548 C&YP [58.2% girls] with median age of 11.9 (IQR 10.8) years.  232 (42.3%) were normotensive; of those hypertensive (n=316), 46 (15%), 83 (26%) and 187 (59%) were WCH, PH and SH respectively. There was a bimodal age distribution for those with SH with peaks in <6 and adolescent years, whereas PH and WCH peaked solely in adolescence. 

Children <6years significantly more likely to have normotension following evaluation using appropriate out-of-office monitoring. If hypertensive, they were significantly more likely to have SH and less likely to have body mass index >95 percentile compared with older children. In those aged <6years, prevalence of WCH and PH both was <0.5% and significantly lower than older age groups.

There were lower numbers of hypertensive children of non-White Ethnicity <6years. Amongst those with hypertension, those of non-White Ethnicity had higher prevalence of PH but comparable rates of WCH when compared with White patients.

Children of normal weight had higher prevalence of non-White ethnicity with PH. Amongst those with excess weight (>85th percentile), significantly more older children but no difference in distribution of hypertension categories by ethnicity [p=0.07]

 

 

 

Conclusions:

Hypertensive young children are most likely to have secondary hypertension and negligible rates of WCH and PH. Primary hypertension including WCH accounts for 40% of hypertension in C&YP in the UK with the highest prevalence in adolescence, non-White Ethnicity and excess weight.