ESPN 50th Annual Meeting

ESPN 2017


 
Prevalence and aetiology of hypertension in Danish children
ADAM FEMERLING LANGHOFF 1 MALENE BøRRESEN 1 MIKAEL ANDERSSON 5 MALGORZATA WASON 2 DORTHE JEPPESEN 1 METTE NELAND 4 IDA-MARIA SCHMIDT 3 DINA CORTES 1

1- Department of Pediatrics, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
2- Department of Pediatrics, Copenhagen University Hospital Hillerød, Hillerød, Denmark
3- Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
4- Department of Pediatrics, Odense University Hospital, Odense, Denmark
5- Department of Pediatrics, The State Serum Institute
6- Faculty of Medical and Health Sciences, University of Copenhagen, Denmark
 
Introduction:

1) To determine prevalence of hypertension in children < 16 years of age in Denmark.

2) To study aetiology of the hypertension and complication at start of pharmacological treatment for hypertension. 

Material and methods:

Using nationwide health registries with ICD-10 codes from hospitalized and out-patient-clinic patients, we extracted data on all hypertensive children seen from 30th April 2014 to 1st May 2015. The prevalence of hypertension in patients < 16 years in Denmark was calculated.

Medical records of all hypertensive children from Central and Eastern Denmark, corresponding to approximately 55% of Danish population, were reviewed and patients with antihypertensive pharmacological treatment were included. 

Results:

The prevalence of hypertension in children < 16 years in Denmark is 0.03% (330/1.030.766).

The prevalence of pharmacologically treated hypertension in children was 0.02% (126/553.784). Of the pharmacologically treated, 82% (103/126) had secondary hypertension. The most common cause was of renal aetiology (n=68). Among the renal patients, 68% (46/68) had decreased glomerular filtration rate and 73% (46/63) had proteinuria. Baseline evaluation of target organ damage was done in most hypertensive children with primary or non-renal aetiologies (n=58), echocardiography in 98% (57/58) of cases and retinal exam in 90% (52/58) of cases. Significantly fewer patients with renal aetiology received echocardiography in 63% (43/68) of cases, (p<0.001) and retinal exam in 60% (41/68) of cases (p<0.001). Among the examined patients, hypertensive retinopathy was found in 23% of patients and septum hypertrophy in 34%  of patients irrespective of cause. 

Conclusions:

Considering the low prevalence of hypertension in children < 16 years in Denmark, Danish national guidelines for blood pressure screening in children should be revised. Furthermore, considering the large proportion of target organ damage

efforts should be done to ensure that hypertensive children undergo thorough evaluation for target organ damage prior to initiation of pharmacological management.