Manson Chon In Kuok, Joanna Newton, Cheentan Singh, Manish D Sinha
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引用次数: 0
Abstract
An accurate measurement of blood pressure (BP) is essential in making a diagnosis of hypertension, however lack of reference values in children <5 years old makes out-of-office BP measurement using ambulatory blood pressure monitoring difficult in this age group. We conducted a retrospective analysis in children aged under 5 years referred to our hypertension service for suspected hypertension. We included those who underwent home doppler blood pressure measurement (HDBPM) for hypertension diagnosis confirmation, and evaluated the investigations performed for suspected hypertension before the diagnosis was confirmed using out-of-office BP measurements. Children receiving anti-hypertensive medication at the time of initial review were excluded. Fifty-five children (62% male) with a median age of 1.6 years completed HDBPM and were included. Nearly 90% of them referred for hypertension were found to be normotensive following out-of-office BP assessment using HDBPM. In these normotensive patients, different investigations for secondary hypertension, including blood tests (creatinine, renin, aldosterone, cortisol, thyroid function tests, and catecholamine levels), doppler kidney ultrasound, and echocardiograms were performed before referral, most of which yielded unremarkable results. Our finding suggested that whilst some initial investigations were essential, second-line tests for less common secondary causes of hypertension are often unnecessary before hypertension is confirmed. We recommend deferring some of these investigations in asymptomatic children until hypertension is verified by home blood pressure measurements.
期刊介绍:
Journal of Human Hypertension is published monthly and is of interest to health care professionals who deal with hypertension (specialists, internists, primary care physicians) and public health workers. We believe that our patients benefit from robust scientific data that are based on well conducted clinical trials. We also believe that basic sciences are the foundations on which we build our knowledge of clinical conditions and their management. Towards this end, although we are primarily a clinical based journal, we also welcome suitable basic sciences studies that promote our understanding of human hypertension.
The journal aims to perform the dual role of increasing knowledge in the field of high blood pressure as well as improving the standard of care of patients. The editors will consider for publication all suitable papers dealing directly or indirectly with clinical aspects of hypertension, including but not limited to epidemiology, pathophysiology, therapeutics and basic sciences involving human subjects or tissues. We also consider papers from all specialties such as ophthalmology, cardiology, nephrology, obstetrics and stroke medicine that deal with the various aspects of hypertension and its complications.