This study highlights that secondary causes dominate hypertension in younger children, whereas essential hypertension is more common in adolescents, and borderline hypertension frequently progresses to fixed hypertension.
Supports age-specific hypertension evaluation in children; hypothesis-generating for borderline progression, requiring prospective confirmation.
Between January 1982 and December 1989 1025 patients aged between one month and 18 years with increased blood pressure were referred for evaluation. Borderline hypertension was found in 389 children; 636 had sustained significant hypertension. In 351 patients, hypertension was secondary to a known disease. Renal parenchymal diseases were present in 68% of patients while renovascular and endocrine disorders were found in 10% and 11%, respectively. Of the 258 children aged less than 15 years, all but six children had known causes of hypertension, while 75% of adolescents had essential hypertension. In the 389 children with borderline hypertension, 65% developed fixed hypertension over a period of 2-3 years.
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Wyszyńska et al. (1992) studied this question.
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