Clinical features of 86 children with essential hypertension complicated with target organ damage

Objective To study the clinical features of target organ damage in children with essential hypertension. Methods From Jan.2007 to Oct.2013, 86 children were enrolled who were diagnosed as essential hypertension in the Children's Hospital Affiliated to Capital Institute of Pediatrics.All children received the following examinations: fundus oculi, electrocardiogram, echocardiography, serum triglyceride, glucose, insulin, C peptide, uric acid, renal function, urine microalbumin, serum and urine β2-microglobulin.All data were collected as standard procedure and analyzed by using statistic methods. Results In all recruited children, there were 68 boys(79.1%)and 18 girls(20.9%)with the average age of (12.3±2.4) years old.There were 46 children(53.5%) with grade Ⅰ hypertension and 40(46.5%)with grade Ⅱ hypertension, 13.5%(7/52 cases)of the children with retinal vessel damage, 21.0%(17/81 cases)with abnormal electrocardiogram, and 2.6%(2/78 cases) with left ventricular hypertrophy and increased left ventricular posterior wall thickness.Thirty-seven percent (30/81 cases) of the children had a higher voltage of R wave in V5 than average values at the same ages.Renal damage mainly included increased serum creatinine and microalbuminuria, with the rates of 40.2%(33/82 cases) and 39.7%(23/58 cases), respectively.Metabolic disorders mainly included 87.5%(56/64 cases) hyperuricemia, 32.5%(25/77 cases) hypertriglyceridemia, 22.1%(19/86 cases) hepatic adipose infiltration, and 36.1%(30/83 cases) hyperinsulinemia or sugar intolerance damage.There were 58(67.4%) children with obesity.Compared with normal weight children, children with obesity had a higher rate of target organ damage(98.3% vs 82.1%, χ2=5.291, P=0.021), and hyperinsulinemia or sugar intolerance damage(45.5% vs 17.9%, χ2=6.123, P=0.013). Children with the course longer than 6 months showed a higher rate of hyperinsulinemia or sugar intolerance damage than the children with the course less than 6 months(50.0% vs 25.5%, χ2=5.788, P=0.021). Conclusions Target organ damage caused by adolescent essential hypertension is present at diagnosis in most of these children.Electrocardiogram and echocardiography are effective measures for early detection of cardiac damage of hypertension.Serum uric caid and urine microalbumin can be used as early warning and screening indexes.To enhance blood pressure monitoring of children with obesity will be helpful for early diagnosis of essential hypertension, which will decrease the rate of target organ damage with earlier effective interference. Key words: Hypertension; Target organ; Child; Adolescent