Risk factors impact on arterial hypertension in children.

Introduction: High blood pressure is the most com-mon cardiovascular disease in adults, leading to early disability and high mortality. The etiology of the hyper-tensive disease is related to intrauterine development period, it is genetically programmed and influenced by the environmental factors. The major risk factors involved in the prognostic of high blood pressure in children are: family history of cardiovascular disease, obesity, sedentary disease, dyslipidemia, increased salt intake, alcohol consumption, smoking, stress, etc.

Objective: To determine the impact of risk factors and to predict their level of influence on the morbidity in-dex in arterial hypertension.

Methods: In our study were enrolled 2055 children aged 10-18 years who were examined according to a special program to estimate the risk factors for high blood pressure. Reactive and personality anxiety was assessed using the Spielberger questionnaire. Depen-ding on the values of the blood pressure assessed at 3 independent visits, the study was divided into two groups: the pre- and hypertensive group (n=326) and a group of the normotensive children (n=1729). The re-lative risk and attributable risk were used to determine the impact of risk factors and to predict their level of influence on the morbidity index.

Results: In this study, the obesity was found in 1.8% (n=38) cases, more frequently – in 5.3 times among pre-and hypertensive children (5.8%) versus normotensi-ves (1.1%), p<0.001. At the same time, the proportion of overweight individuals among pre- and hypertensive versus normotensive children was estimated to be hi-gher in 3 times (13.2% vs. 4.3%, p<0.001). An increased eredocolateral history of the hypertensive disease was reported in 61.8% (n=643) cases, more frequently in pre- and hypertensive children (69.4%) versus normo-tensive (60.1%), p<0.05. Milk formula was applied in the first day of life more frequently in pre- and hyper-tensive children (17.6%) compared to normotensive (11.9%) (χ²=4.22; p<0.05). Between the study groups, it was found that pre- and hypertensive children were more likely to be born with small body mass (8.8%), compared to normotensive children (4.8%) with sta-tistical authenticity (χ2=3.98; p<0.05). Pre- and hyper-tensive children more often have high-grade of reactive and personality anxiety versus normotensive subjects (73% versus 36%, p<0.001). The analysis of the relati-ve and attributable risk of high blood pressure deve-loping in childhood demonstrated that it was the hi-ghest among the children with high anxiety (OR=4.81) followed by obese children (OR=4.13) with a history (OR=2.43), those with a small birth weight (OR=1.9), followed by children feeded by milk formula during the first 6 months of life (OR=1.68). The lowest risk was at-tributed to the excessive consumption of high salt pro-ducts (OR=1.02), sedentary (OR=1.12) and cigarette smoke exposure (OR=1.2).

Conclusions: Using relative and attributable risk, it was estimated that the highest risk of developing high blood pressure in childhood is due to children with high anxiety and obesity, followed by children with a family history of hypertensive disease, especially on the mother’s line, feeded by milk formula in the first 6 months of life and small body weight at birth.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)