Epidemiological, Diagnostic, Therapeutic and Progressive Aspects of Arterial Hypertension in Children at the University Hospital Center of Bouaké (Côte d’Ivoire)
Introduction: Arterial hypertension (AH) in
children is under-diagnosed and often has a poor prognosis. The aim of this study was to describe
the epidemiological, diagnostic, therapeutic and evolutionary aspects of
hypertension in children at the University Hospital of Bouaké, with a view to
improving the prognosis.Methods: This was a cross-sectional, analytical study
carried out in the paediatrics department of Bouaké University Hospital. It
concerned the medical records of children aged 4 to 15 hospitalised from 1
January 2017 to 31 December 2020 for hypertension. Diagnosis was based on the
simplified blood pressure guidelines of the Expert Consensus of the French
Society of Hypertension. The variables studied were epidemiological,
diagnostic, therapeutic and evolutionary. Quantitative variables were compared
at the significance level p ≤ 0.05.Results: The hospital incidence of hypertension was 0.32%
(69/21,642). The sex ratio was 0.72. 97.1% of the children were over five years
of age. Oedema (49.3%) and breathing difficulties (20.2%) were the main reasons for consultation. Hypertension was
classified as threatening (56.5%), confirmed (31.9%) and borderline
(11.6%). The cause was renal in 66.7%,
dominated by impure nephrotic syndrome (24.6%). Treatment for
hypertension consisted mainly of a diuretic (79.7%) and a calcium channel blo
References
[1]
André, J.L. (1993) épidémiologie de l’hypertension artérielle. In: Loirat, C., Niaudet, P., Eds., Progrès en néphrologie pédiatrique, Doin, Paris, 193-202.
[2]
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics, 114, 555-576.
[3]
Rosner, B., Cook, N.R., Daniels, S. and Falkner, B. (2013) Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure: The NHANES Experience 1988-2008. Hypertension, 62, 247-254.
https://doi.org/10.1161/HYPERTENSIONAHA.111.00831
[4]
Song, P., Zhang, Y., Yu, J., Zha, M., Zhu, Y., Rahimi, K., et al. (2019) Global Prevalence of Hypertension in Children: A Systematic Review and Meta-Analysis. JAMA Pediatrics, 173, 1154-1163. https://doi.org/10.1001/jamapediatrics.2019.3310
[5]
Koebnick, C., Black, M.H., Wu, J., Martinez, M.P., Smith, N., Kuizon, B.D., et al. (2013) The Prevalence of Primary Pediatric Prehypertension and Hypertension in a Real-World Managed Care System. The Journal of Clinical Hypertension, 15, 784-792. https://doi.org/10.1111/jch.12173
[6]
De Moraes, A.C.F., Lacerda, M.B., Moreno, L.A., Horta, B.L. and Carvalho, H.B. (2014) Prevalence of High Blood Pressure in 122,053 Adolescents: A Systematic Review and Meta-Regression. Medicine, 93, Article e232.
https://doi.org/10.1097/MD.0000000000000232
[7]
Hansen, M.L., Gunn, P.W. and Kaelber, D.C. (2007) Underdiagnosis of Hypertension in Children and Adolescents. JAMA, 298, 874-879.
https://doi.org/10.1001/jama.298.8.874
[8]
Vergnaud, P. and Bertail-Galoin, C. (2023) Découverte d’une HTA chez l’enfant. Perfectionnement en Pédiatrie, 6, S6-S9.
https://doi.org/10.1016/S2588-932X(23)00096-7
[9]
Falkner, B., Gidding, S.S., Ramirez-Garnica, G., Wiltrout, S.A., West, D. and Rappaport, E.B. (2006) The Relationship of Body Mass Index and Blood Pressure in Primary Care Pediatric Patients. The Journal of Pediatrics, 148, 195-200.
https://doi.org/10.1016/j.jpeds.2005.10.030
[10]
Rerksuppaphol, L. and Rerksuppaphol, S. (2021) Prevalence and Risk Factors of Hypertension in Schoolchildren from Central Thailand: A Cross-Sectional Study. International Journal of Preventive Medicine, 12, 1-6.
[11]
Kuissi Kamgaing, E., Allognon, M.C., Minto’o, S., Mboungou Ikouanga, R., Koumba Maniaga, R., Mintsa Mi Nkama, E., et al. (2022) Aspects épidémiologiques et facteurs associés à l’hypertension artérielle de l’enfant en milieu scolaire à Libréville en 2021. Health Sciences and Disease, 23, 11-15.
[12]
André, J.L. (2005) Hypertension artérielle chez l’enfant et l’adolescent. EMC-Cardiologie-Angéiologie, 2, 478-490. https://doi.org/10.1016/j.emcaa.2005.07.008
[13]
Asse, K.V., Akaffou, E., Ake-Assi-Konan, M.H., Adonis-Koffy, L.Y., Timite-Konan, A.M. and Kouassi, F.L. (2012) Hypertension artérielle de l’enfant à Abidjan (Côte d’Ivoire): Aspects diagnostiques, thérapeutiques et évolutifs à propos de 30 cas. Revue Africaine d’Anesthésiologie et de Médecine d’Urgence (RAMUR), 17, 53-58.
[14]
Société Française d’Hypertension Artérielle (2020) HTA de l’enfant et de l’adolescent. Consensus d’Experts de la. https://www.sfhta.eu
[15]
Mbolla, B.F.E., Okoko, A.R., Babela, J.R.M., Bowassa, G.E., Gombet, T.R., Kimbally-Kaky, S.-G., et al. (2014) Prehypertension and Hypertension among School Children in Brazaville, Congo. International Journal of Hypertension, 2014, Article ID: 803690. https://doi.org/10.1155/2014/803690
[16]
Aounallah-Skhiri, H., El Ati, J., Traissac, P., Ben Romdhane, H., Eymard-Duvernay, S., Delpeuch, F., et al. (2012) Blood Pressure and Associated Factors in a North African Adolescent Population. A National Cross-Sectional Study in Tunisia. BMC Public Health, 12, Article No. 98. https://doi.org/10.1186/1471-2458-12-98
[17]
Steyn, N.P. and McHiza, Z.J. (2014) L’obésité et la transition nutritionnelle en Afrique sub-saharienne. Annals of the New York Academy of Sciences, 1311, 88-101.
https://doi.org/10.1111/nyas.12433
[18]
Lemogoum, D., Kandem, F., Bika Lele, C., Guetchuin, S.C., Kenmegne, C., Luma, H., et al. (2016) Hypertension artérielle et facteurs de risque associés chez les adolescents en milieu scolaire au Cameroun. Revue de Médecine et de Pharmacie, 6, 602-611.
[19]
Kakoma, P.K., Muyumba, E.K., Mukeng, C.K., Musung, J.M., Kakisingi, C.N., Mukuku, O., et al. (2018) Profil pressionnel de l’adolescent en milieu scolaire à Lubumbashi, République Démocratique du Congo. Pan African Medical Journal, 29, Article 94. https://doi.org/10.11604/pamj.2018.29.94.14537
[20]
Nam, E.W., Sharma, B., Kim, H.Y., Paja, D.J., Yoon, Y.M., Lee, S.H., et al. (2015) Obesity and Hypertension among School-Going Adolescents in Peru. Journal of Lifestyle Medicine, 5, 60-67. https://doi.org/10.15280/jlm.2015.5.2.60
[21]
Patel, A., Bharani, A., Sharma, M., Bhagwat, A., Ganguli, N. and Chouhan, D.S. (2019) Prevalence of Hypertension and Prehypertension in Schoolchildren from Central India. Annals of Pediatric Cardiology, 12, 90-96.
https://doi.org/10.4103/apc.APC_13_18
[22]
Ye, X., Yi, Q., Shao, J., Zhang, Y., Zha, M., Yang, Q., et al. (2021) Trends in Prevalence of Hypertension and Hypertension Phenotypes among Chinese Children and Adolescents over Two Decades (1991-2015). Frontiers in Cardiovascular Medicine, 8, 627-741. https://doi.org/10.3389/fcvm.2021.627741
[23]
Gupta-Malhotra, M., Banker, A., Shete, S., Hashmi, S.S., Tyson, J.E., Barratt, M.S., et al. (2015) Essential Hypertension vs. Secondary Hypertension among Children. American Journal of Hypertension, 28, 73-80. https://doi.org/10.1093/ajh/hpu083
[24]
André, J.L. (2006) Hypertension artérielle chez l’enfant et l’adolescent. EMC-Cardiologie, 19, 1-10. https://doi.org/10.1016/S1166-4568(05)39433-2
[25]
Rutigliano, I., De Filippo, G., Pastore, L., Messina, G., Agostoni, C. and Campanozzi, A. (2021) Obesity-Related Hypertension in Pediatrics, the Impact of American Academy of Pediatrics Guidelines. Nutrients, 13, Article 2586.
https://doi.org/10.3390/nu13082586
[26]
Sun, S.S., Grave, G.D., Siervogel, R.M., Pickoff, A.A., Arslanian, S.S. and Daniels, S.R. (2007) Systolic Blood Pressure in Childhood Predicts Hypertension and Metabolic Syndrome Later in Life. Pediatrics, 119, 237-246.
https://doi.org/10.1542/peds.2006-2543
[27]
Kaczmarek, M., Stawińska-Witoszyńska, B., Krzyżaniak, A., Krzywinska-Wierowska, M. and Siwiriska, A. (2015) Who Is at Higher Risk of Hypertension? Socioeconomic Status Differences in Blood Pressure among Polish Adolescents: A Population-Based ADOPOLNOR Study. European Journal of Pediatrics, 174, 1461-1473.
https://doi.org/10.1007/s00431-015-2554-0
[28]
Koueta, F., Ouedrogo-Yugbare, S.O., Some, A.M., Boly, C., Dao, L., Sawadogo, H., et al. (2013) Profil de l’hypertension artérielle de l’enfant en milieu hospitalier pédiatrique à Ouagadougou (Burkina Faso). Sciences de la Santé, 1, 36-40.
[29]
Olson, D.L. and Lieberman, E. (1991) Renal Hypertension in Children. Child Nephrology and Urology, 11, 152-158.
[30]
Aysun, K.B., Fatos, Y., Nilgun, C., Ali, D., Zelal, B. and Aysin, B. (2007) Reno-Vascular Hypertension in Childhood: A Nationwide Survey. Pediatric Nephrology, 22, 1327-1333. https://doi.org/10.1007/s00467-007-0520-4
[31]
Sebire, G., Husson, B. and Lasser, C. (1995) Encéphalopathie induite par l’hypertension artérielle: Aspects cliniques, radiologiques et thérapeutiques. Archives de Pédiatrie, 2, 513-518. https://doi.org/10.1016/0929-693X(96)81193-6
[32]
Grinsell, M. and Norwood, V. (2009) At the Bottom of the Differential Diagnosis List: Unusual Causes of Pediatric Hypertension. Pediatric Nephrology, 24, 2137-2146. https://doi.org/10.1007/s00467-008-0744-y
[33]
Douglas, M.S., Champoux, E., Diego, H.A. and Vehaskari, V.M. (2006) Treatment of Primary and Secondary Hypertension in Children. Pediatric Nephrology, 21, 820-827. https://doi.org/10.1007/s00467-006-0087-5
[34]
Aderele, W.I. and Seriki, O. (1974) Hypertension in Nigerian Children. Archives of Disease in Childhood, 49, 313-317. https://doi.org/10.1136/adc.49.4.313
