[Etiology and blood pressure patterns in secondary hypertension in children].
Most studies regarding the etiology of hypertension in children have found a frequency of secondary hypertension 4 to 9 times greater the than in adults (70-90% vs. 10%), with a probability of identifying an underlying disease inversely related with the age and directly related with the severity of hypertension.


METHODS
The purpose of this study is to establish the causes and the patterns of hypertension in a group of 256 children, admitted during a five-year period in the Children's Hospital "Sf. Maria" Iaşi, Romania.


RESULTS
The frequency of secondary hypertension is 4 times greater than essential hypertension. The most frequent causes of secondary hypertension are renal parenchymal disease (83.2%) and cardiovascular disease (coarctation of the aorta) (11.4%); less frequent have been diagnosed neurologic (1%) and endocrinologic diseases (1.5%). Most of the assessed cases (referred to our hospital for different other reasons) have been found with stage 1 and 2 of hypertension right from the moment of admission (88.3%). We established a statistically significant relationship between the severity of hypertension and the secondary type of hypertension, meaning : the higher the blood pressure (BP)--the higher chances of diagnosing an underlying cause of hypertension. Among the secondary causes, the renal or non-renal etiology did not significantly influence the BP values at the moment of admission. Among the different histological types of chronic glomerulonephritis, focal segmental glomerulosclerosis presented with a significant higher BP comparing with the other types.


CONCLUSIONS
the frequency of hypertension increased with age: 92.6% of essential hypertension cases belong to age 11-18, 59.2% of renal hypertension cases belong to age 11-18. The exception came from cardiovascular hypertension, which fit into age group 0-6 year old (p < 0.05%). The gender had no significant influence of the etiology of hypertension.
Gavrilovici
Cristina
C
Clinica a IV-a Pediatrie, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr. T. Popa", Iaşi.
Boiculese
L V
LV
Brumariu
O
O
Dimitriu
A G
AG
D000293:Adolescent; D000704:Analysis of Variance; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D009422:Nervous System Diseases / Q000150:complications; D012383:Romania / Q000453:epidemiology; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric