Current etiology of hypertension in European children -- role of serum uric acid

2.BackgroundWhile hypertension (HT) in pediatric patients is often secondary (SH), recent trends show a rise in primary hypertension (PH), which is associated with an increasing global prevalence of obesity. Our study aimed to assess the etiology of HT and predictors of PH in a large European cohort of children referred for HT based on office blood pressure (BP) measurements. MethodsWe performed retrospective analysis of 2008 children aged 0-18 years (12.3 {+/-} 4.9 years) diagnosed with HT. Patients were classified into white coat hypertension (WCH), PH, or SH groups based on office BP and 24-hour ambulatory BP monitoring (ABPM). Clinical, anthropometric, and biochemical data were collected to differentiate PH and SH and to identify predictors of PH. ResultsOut of 2008 patients included in the analysis, HT was confirmed in 1452 patients (556 were classified as WCH). Of 1452 patients with HT: 42.8% had PH, while 57.2% had SH, mainly secondary to renal parenchymal disease (33.2% of SH patients), post-kidney transplant HT (23.1%), aortic coarctation (15.9%) and renovascular HT (13.8%). However, PH started to be the dominant cause of HT after 13 years of age and was diagnosed in 59.1% of 13-18-year-old patients with confirmed HT. Age [≥] 13 years, obesity (BMI-SDS [≥]1.65), and serum uric acid [≥] 5.5 mg/dL were identified as significant PH predictors. ConclusionsOur study provides valuable insights into the current etiology of pediatric HT and highlights the role of uric acid level assessment in the diagnosis of PH in children.