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A STUDY OF ESSENTIAL HYPERTENSION RISK FACTORS IN CHILDREN

Manju Lata Sharma

M.N. Hospital & Research Center, Bikaner, India

Cardiovascular diseases exert widely differing contributions to the total burden of mortality and morbidity in extant human populations. To a large extent these differences are a reflection of the variable distribution of specific antecedent risk factors for one such risk factor is blood pressure. Essential hypertension although primarily a disease of adulthood is increasingly encountered in children.

Objectives: 1. To study the essential hypertension in children whose parents or grand parents had essential hypertension. 2. To identify the markers if any. To detect later development of essential hypertension.

Design: Prospective study from November 1998 to November 2000.

Setting: Urban Private Hospital

Material and Methods: Sixty children (5-8 years) with a positive history were enrolled in the study group, while the control group had 20 children (2-16 years). Measurement of blood pressure of children and parents were done. Both groups were compared with anthropomontary including skin fold thickness, diet (calories, proteins, salt, fat intake). Biochemical studies included lipid profile, serum calcium and a 24 hours urinary electrolyte. P value was used for statistical analysis.

Results: 15 children had a diastolic blood pressure – more than 95 per centile (P<0.0001) in contrast to none in the control group. Obese children had higher blood pressure in both groups. The study group had a significantly richer diet in fat and salt (P<0.001) as compared to the control group. Serum cholestral and serum triglyceride were higher in 3 patient out of 15 in study group (P<0.05). Serum calcium showed no such difference. The urinary sodium were higher in 3 patients in the study group, none in control group (P<0.05).

Conclusion: It is possible to quantify risk factors in children who have positive family history of essential hypertension. They are at increased risk of developing essential hypertension in the future. So preventive measures to be taken by pediatricians are: to identify the child at risk of essential hypertension by screening of children by close monitoring of blood pressure in children with obesity, a high serum cholestral, serum triglyceride and high 24 hour urinary sodium exertion should be done to detect later development of essential hypertension. Advocacy of life style that embraces dietary modification, ideal weight, exercises to avert future complications.