Prevalence of Secondary Hypertension in Otherwise Healthy Youths with a New Diagnosis of Hypertension: A Meta-Analysis - 06/05/22
, Chelsea Young, MD 1, Melissa C. Funaro, MS, MLS 3, Kuan Jiang, BS 2, Ishan Saran, BS 2, Lama Ghazi, MD, PhD 2, F. Perry Wilson, MD, MSCE 2, 4, Jason H. Greenberg, MD, MHS 1, 2Abstract |
Objective |
To estimate the prevalence of secondary hypertension among otherwise healthy children with hypertension diagnosed in the outpatient setting.
Study design |
The MEDLINE, PubMed Central, Embase, Web of Science, and Cochrane Library databases were systematically searched for observational studies reporting the prevalence of secondary hypertension in children who underwent evaluation for hypertension and had no known comorbidities associated with hypertension at the time of diagnosis. Two authors independently extracted the study-specific prevalence of secondary hypertension in children evaluated for hypertension. Prevalence estimates for secondary hypertension were pooled in a random-effects meta-analysis.
Results |
Nineteen prospective studies and 7 retrospective studies including 2575 children with hypertension were analyzed, with a median of 65 participants (range, 9-486) in each study. Studies conducted in primary care or school settings reported a lower prevalence of secondary hypertension (3.7%; 95% CI, 1.2%-7.2%) compared with studies conducted in referral clinics (20.1%; 95% CI, 11.5%-30.3%). When stratified by study setting, there were no significant subgroup differences according to study design, country, participant age range, hypertension definition, blood pressure device, or study quality. Although the studies applied different approaches to diagnosing secondary hypertension, diagnostic evaluations were at least as involved as the limited testing recommended by current guidelines.
Conclusions |
The low prevalence of secondary hypertension among children with a new diagnosis of hypertension identified on screening reinforces clinical practice guidelines to avoid extensive testing in the primary care setting for secondary causes in most children with hypertension.
Le texte complet de cet article est disponible en PDF.Keywords : secondary hypertension, primary hypertension, high blood pressure, systematic review, meta-analysis
Abbreviations : AAP, ABPM
Plan
| F.W. has received funding through Grants R01 DK113191 and P30 DK079310 from the National Institute of Diabetes and Digestive and Kidney Diseases and Grant R01 HS027626 from the Agency for Healthcare Research and Quality, United States. J.G. has received funding through Grant K08 DK110536 from the National Institute of Diabetes and Digestive and Kidney Diseases and the Child Health Foundation, United States. The authors declare no conflicts of interest. |
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| Portions of this study were presented as an abstract during the American Society of Nephrology Kidney Week, San Diego, CA, November 4-7, 2021. |
Vol 244
P. 30 - mai 2022 Retour au numéro
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