Childhood hypertension is not a silent disease
Childhood hypertension is not a silent disease
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DOI：
10.1007/s00467-006-0013-x
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发表时间：
2006-04-01
影响因子：
3
通讯作者：
Feig, DI
中科院分区：
文献类型：
--
作者：
Croix, B;Feig, DI
早期高血压通常被认为是一种无症状的疾病，然而，最近的数据显示，许多高血压儿童有终末器官损害的证据。我们试图确定一系列常见症状是否与早期高血压有关，以及这些症状是否随血压降低而消退。409名7-18岁的儿童在德克萨斯州儿童医院高血压诊所接受新发高血压（BP）检查，完成了一份问卷调查，包括自我报告的15种可能归因于高血压的症状。受试者接受抗高血压治疗，并在治疗开始后4-6个月重复问卷调查。150名健康、血压正常的儿童作为对照完成了问卷调查。在高血压儿童中，64%有症状，而血压正常儿童中有症状的仅为26%（P < 0.001）。51%的高血压儿童报告1-4个症状，14% > 4个症状。治疗后，只有28%的儿童仍然有症状。高血压患者头痛、入睡困难和白天疲劳三大常见症状的发生率分别为42%、27%和26%，治疗后分别下降到6.2%、1.5%和10%（P < 0.001）。我们的结论是，新诊断的高血压儿童有各种非特异性症状，比血压正常的儿童更普遍，大多数躯体疾病的投诉改善4-6个月的抗高血压治疗。
Early hypertension has generally been considered to be an asymptomatic condition; however, recent data show that many hypertensive children have evidence of end organ damage. We sought to determine if a spectrum of common symptoms is associated with early hypertension and whether those symptoms resolve with lowered blood pressure. Four hundred and nine consecutive children, 7-18 years old, examined in the Texas Children's Hospital Hypertension Clinic for new-onset high blood pressure (BP) completed a questionnaire, including the self-reporting of 15 symptoms potentially attributed to high blood pressure. Subjects received anti-hypertensive treatment and repeated the questionnaire 4-6 months after initiation of therapy. One-hundred fifty healthy, normotensive children completed the questionnaire as controls. Of hypertensive children, 64% were symptomatic, compared with 26% of normotensive children (P < 0.001). Fifty-one percent of hypertensive children reported 1-4 symptoms, 14% > 4 symptoms. Following treatment only 28% of children remained symptomatic. The three most common symptoms in hypertensive patients, headache, 42%, difficulty initiating sleep, 27%, and daytime tiredness, 26%, were markedly reduced with treatment, to 6.2%, 1.5% and 10%, respectively (P < 0.001). We conclude that newly diagnosed hypertensive children had a variety of non-specific symptoms, more prevalent than those of normotensive children, and most somatic complaints improved with 4-6 months of anti-hypertensive treatment.