DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20211665

Study of clinical and etiological profile of hypertensive emergencies in children admitted in pediatric emergency department

Sumathi Kotapuri, Mahendranath Putta, Sudharshanraj Chitgupikar

Abstract


Background: Hypertension (HTN) in children, all though an uncommon entity is associated with end-organ damage. With increasing prevalence of hypertension and obesity in children; hypertensive emergencies are also increasing over recent years and screening is must. The primary objective of this study was to determine the incidence of hypertensive emergencies, the clinical presentation and etiological diagnosis at different age groups and to access the real burden of primary hypertension in causing hypertensive emergencies in children.

Methods: This study was a prospective, descriptive, analytical cohort study done on children attending the emergency department of pediatrics, government general hospital, a tertiary referral pediatric center attached to Kurnool medical college, Kurnool, over a period of 18 months i.e., from january2016 to June 2017. Data was collected in a pre-determined proforma after institutional ethical committee clearance and appropriate informed concerned.

Results: Among 98 children with hypertension; 30 had hypertensive emergency.  Incidence was 0.3%. Intrinsic renal and renal vascular causes were the commonest. Headache, dizziness and vomiting were the comment presentation. Half of them had encephalopathy. Younger children had more of secondary HTN and in children (older than 7 years) primary hypertension increased as did family history of hypertension.

Conclusions: With increasing primary hypertension among older children, hypertensive emergencies are increasing. As most of the children with HTN are asymptomatic; detection of target organ damage is vital.


Keywords


Pediatric hypertension, Hypertensive emergencies, Incidence, Clinical presentation

Full Text:

PDF

References


Singhi SC, Kohli V. Management of hypertensive emergencies. Continuing medical education. 1992;1181-6.

World health organization a global brief on hypertension, world health day. 2013;5-6.

Patel NH, Romero RK, Kaelber DC. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies. Open access emerg med. 2012; 4:85-92.

Seeman T, Dusek J, Vondrichova H, Kyncl M, John U, Misselwitz J et al. Ambulatory blood pressure correlates with renal volume and number of renal cysts in children with autosomal dominant polycystic kidney disease. Blood press monit. 2003;8:107-10.

Mazur L, Lacy B, Wilsford L. the prevalence of hypertension in children with spina bifida. Acta paediatr. 2011;100:80-83.

Kota SK, Meher LK, Sruti J, Kotn G, Panda S, Tripathy PR et al. Clinical analysis of hypertension in children: an urban Indian study. Saudi j kidney dis transpl. 2013;24(4):844-52.

Falkner B. Hypertension in children and adolescents: epidemiology and natural history pediatr nephrol. 2010;25(7):1219-24.

Pranam GM, Pranam UG, Manjunath GA. Prevalence of hypertension among adolescents. Pediatric review: int j pediatr res. 2015;4:29-33.

Gulati S. Childhood hypertension. Indian pediatr. 2006;43:326-33.

Hari P, Bagga A, Srivastava N. Sustained hypertension in children. Indian pediatr. 2000;37:268-74.

Anand NK, Tandoon L. Prevalence of hypertension in school going children, Indian pediatrics. 1996;33:377-91.

Martin JF, Higashiama E, Garcia E, Luizon MR, Cipullo JP. Hypertensive crisis profile. Prevalence and clinical presentation. Arq bras cardiol. 2004;83:131-6;125-30.

Chandar J, Zilleruelo G. Hypertensive crisis in children. Pediatr nephrol. 2012;27:741-51.

Yang W, Zhao L, Chen C, Wu Y, Chang Y, Wu H. First-attack pediatric hypertensive crisis presenting to the paediatric emergency department. Br med j pediatr. 2012;12:200-7.

Baracco R, Mattoo TK. pediatric hypertensive emergencies. Curr hypertens rep. 2014;16:456.

Wyszynska T, Cichocka E, Wieteska-kimczak A, Januszewicz P. A single pediatric center experience with 1025 children with hypertension. Acta paediatr. 1992;81:244-6.

Gill DG, Mendis da costa B, Cameron JD, Joseph MC, Ogg CS, Chantler C. Analyses of 100 children with severe and persistent hypertension. Arch dis child. 1976;51:951-6.

Arar MY, Hogg RJ, Arant jr BS, Seikaly MG. Etiology of sustained hypertension in children in the southwestern united states. Pediatr nephrol. 1994;8:186-9.