Hypertension crisis as the first symptom of renovascular hypertension in children

Italian Journal of Pediatrics

Research

Youzhen Qin¹  Hongjun Ba¹  Lingling Xu²  Xiaoyun Jiang² 

[1] Department of Pediatric Cardiovascular, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Second Road, 510080, Guangzhou, Guangdong, People’s Republic of China;Department of Pediatrics, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Second Road, 510080, Guangzhou, Guangdong, People’s Republic of China;

关键词: Renovascular hypertension;    Children;    Hypertensive crisis;    Hypertensive urgency;    Hypertensive emergency;   

DOI  :  10.1186/s13052-022-01378-4

 received in 2022-01-10, accepted in 2022-11-01,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRenovascular hypertension (RVH) is one of the main causes of hypertensive crisis (HTN-C). It is characterized by acute onset and severe disease, and early diagnosis and treatment are difficult. The objective was to describe the characteristics of RVH and factors associated with RVH leading to HTN-C in children. At present, there are few clinical studies on RVH in children with large cases in China.MethodsThis study retrospectively analyzed the clinical data of inpatient children with RVH. Patients were divided into non-hypertensive crisis (non-HTN-C) group, and HTN-C group according to the first symptoms and blood pressure. Further, HTN-C were classified as hypertensive urgency (HTN-U) or hypertensive emergency (HTN-E).ResultsFifty-four pediatric cases (41 boys and 13 girls) were included. 83.3% of the RVH cases were ≥ 6 years old. Three cases were classified into the non-HTN-C group. Of the 51 HTN-C cases, 18 cases were grouped as HTN-U and 33 as HTN-E. The HTN-U group were mainly asymptomatic (50.0%, 9/18) while the HTN-E group mainly presented with neurological symptoms (72.7%, 24/33). The number of unknown etiology children was 32 (59.2%). The top three known etiologies were Takayasu’s arteritis (50.0%, 11/22), congenital renal dysplasia (27.3%, 6/22) and fibromuscular dysplasia (13.6%, 3/22). As for the target organ damage of RVH, patients had a higher prevalence of left ventricular hypertrophy (71.4%, 35/49) and retinopathy (77.8%, 21/27).ConclusionsMost RVH patients with HTN-C as the first symptoms, especially for males over 6 years old, should be assessed for RVH even if they were asymptomatic. Most asymptomatic patients with RVH already had target organ damage, and symptomatic patients even developed life-threatening complications. As preventive measures, routine monitoring of BP during children’s physical examinations is advised.

【 授权许可】

CC BY   
© The Author(s) 2022

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