Clinical data analysis of hospitalized adolescent patients with hypertension

Objective To explore clinical characteristics and risk factors of adolescent patients with hypertension.MethodsA total of 233 adolescent inpatients aged 14 to 24 years old from 2004 to 2009 were enrolled.The disease history,family history,height,weight,office blood pressure,fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN),creatinine(CR),serum uric acid(SUA)and 24-hour urinary sodium were collected.The data from 24-hour ambulatory blood pressure monitoring and transthoracic echocardiography were also recorded.ResultsAmong adolescent hypertension patients,secondary hypertension accounted for 20%(46/233)and essential hypertension accounted for 80%(187/233).Among essential hypertension,58.82%(110/187)patient had metabolic abnormality,in which overweight(19.25%)and obesity(18.72%)were more common.Compared with female,male patients had higher body mass index,systolic blood pressure and uric acid level,but lower average heart rate and HDL-C level.There was no significant difference in biochemical indexes and target organ damage between positive and negative family history of hypertension groups(P0.05).Multiple linear regression analysis showed that systolic blood pressure positively correlated with body mass index(β=0.362,P=0.012)and duration(β=0.408,P=0.004),and diastolic blood pressure positively correlated with uric acid(β=0.718,P=0.002)and age(β=0.376,P=0.015).The most common target organ damage taking 19.05%(32/168)was left ventricular hypertrophy.And left ventricular hypertrophy index was positively related with BMI,24hSBP and 24hDBP that suggested by multiple liner regression.In logistic regression,BMI was the main risk factors to left ventricular hypertrophy(OR 1.209,95% CI 1.084-1.348).ConclusionMost of hypertensive adolescents(80%)have no apparent identifiable secondary cause of hypertension.Metabolic disorders such as high serum uric acid which closely related with blood pressure should be actively corrected,and the aggregation of cardiovascular risk factors and targetorgan damage should be controlled.