Primary hypertension at a single center: Treatment, time to control, and extended follow-up

Amy DiPietro, Deborah Kees-Folts, Susan DesHarnais, Fabian Camacho, Steven Wassner

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

We present data on presentation, treatment, and follow-up of 65 pediatric patients with primary hypertension treated over the past 12 years, including initial anthropometric data, pharmacologic treatment, time to control for both systolic and diastolic blood pressure (SBP/ DBP), and maintenance of control over time. Data was normalized to standard deviation scores (SDS) for mathematical analysis, and antihypertensive medication dosages were converted to dosage equivalents for a single member of each antihypertensive class. We used multiple regression analysis and Kaplan-Meier survival curves to determine the time to control, medication, and dose effectiveness. Patients were seen for an average of seven visits over 25 months. Initial BPs averaged 134/71 mmHg (2.1/0.6 SDS). Patients were taller, heavier, and had higher body mass index than average for age and sex. By the fourth visit, SBP was <90th percentile in 79%. Ninety percent could be controlled, although 32 lost control at some point (at least 16 due to noncompliance). At the last visit, 46 were controlled, and 5/8 patients off medication remained normotensive. Only angiotensin-converting enzyme inhibitors and β-blockers demonstrated significant association with BP control. This is the first study to document the time to control of BP, and it can serve as an initial standard for quality assessment.

Original languageEnglish (US)
Pages (from-to)2421-2428
Number of pages8
JournalPediatric Nephrology
Volume24
Issue number12
DOIs
StatePublished - Aug 31 2009

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Hypertension
Antihypertensive Agents
Blood Pressure
Kaplan-Meier Estimate
Therapeutics
Angiotensin-Converting Enzyme Inhibitors
Body Mass Index
Regression Analysis
Maintenance
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

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abstract = "We present data on presentation, treatment, and follow-up of 65 pediatric patients with primary hypertension treated over the past 12 years, including initial anthropometric data, pharmacologic treatment, time to control for both systolic and diastolic blood pressure (SBP/ DBP), and maintenance of control over time. Data was normalized to standard deviation scores (SDS) for mathematical analysis, and antihypertensive medication dosages were converted to dosage equivalents for a single member of each antihypertensive class. We used multiple regression analysis and Kaplan-Meier survival curves to determine the time to control, medication, and dose effectiveness. Patients were seen for an average of seven visits over 25 months. Initial BPs averaged 134/71 mmHg (2.1/0.6 SDS). Patients were taller, heavier, and had higher body mass index than average for age and sex. By the fourth visit, SBP was <90th percentile in 79{\%}. Ninety percent could be controlled, although 32 lost control at some point (at least 16 due to noncompliance). At the last visit, 46 were controlled, and 5/8 patients off medication remained normotensive. Only angiotensin-converting enzyme inhibitors and β-blockers demonstrated significant association with BP control. This is the first study to document the time to control of BP, and it can serve as an initial standard for quality assessment.",
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Primary hypertension at a single center : Treatment, time to control, and extended follow-up. / DiPietro, Amy; Kees-Folts, Deborah; DesHarnais, Susan; Camacho, Fabian; Wassner, Steven.

In: Pediatric Nephrology, Vol. 24, No. 12, 31.08.2009, p. 2421-2428.

Research output: Contribution to journalArticle

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