Alpan CURA, Sevgi MİR, Caner KABASAKAL, Osman DÖNMEZ

Çocuk yaş grubu hipertansiyonlarının toplu sonuçları

Günümüzde çocukluk yaş grubu hipertansiyonları hem tanı hem de tedavi güçlüğü gösteren en önemli sorunlardan biridir. Bu çalışmada çocuklarda hipertansiyonun nedenleri, hedef organ tutuluşu, tedavi ve yaklaşık bir yıllık izlem sonuçları sunulmak istenmiştir. Yaş ortalaması 10.6±3.8 yıl olan hipertansiyonlu 94 (43 kız, 51 erkek) çocuk incelenmiştir. Çalışmaya alınan 94 çocuğun %26'sında esansiyel hipertansiyon, %74'ünde (30 kız, 40 erkek) sekonder hipertansiyon saptanmıştır. Esansiyel hipertansiyonlu 7 olguda (%29.2) hedef organ tutuluşu bulunmuştur. Esansiyel hipertansiyon grubunda kan basıncı kontrolü, çocukların %29'unda sadece tuz ve/veya kaloriden kısıtlı diyet ile, %47'sinde tek antihipertansif ilaç ile ve %24'ünde ilaç kombinasyonu eklenerek sağlanmıştır. Sekonder hipertansiyon nedenlerinin %31.4 kronik glomerülonefrit, %20 idrar yolu enfeksiyonuna bağlı nefropati, %17.1 akut glomerülonefrit ve %31.5 diğer nedenler olduğu görülmüştür. Hedef organ tutuluşu sekonder hipertansiyonlu çocukların 24'ünde (%34.2) gözlenmiştir. Bu grupta kan basıncı %50 olguda tek antihipertansif ilaç, %44 olguda çeşitli ilaç kombinasyonları ve %4 olguda nonfarmakolojik tedavi ile kontrol altına alınmıştır. Sonuç olarak, hipertansiyonlu çocukların 1/4'ünde esansiyel hipertansiyon olduğu, 1/3'ünde hedef organ tutuluşu bulunan olguların genelde hastalığın ileri evresinde başvurduğu ve yarıdan fazlasında tek ilaç tedavisinin kan basıncını kontrol altına almaya yetmediği saptanmıştır.

Anahtar Kelimeler:

Antihipertansif ajanlar, Kan basıncı, Çocuk, Tanı, ayırıcı, Hipertansiyon

Hypertension in childhood age group

Hypertension with difficulties in diagnosis and treatment is one of the most important problems in children. In this study causes, end organ damage, the results of treatment and follow up of childhood hypertension were studied. Ninety-four hypertensive children (43 girls, 51 boys) with the mean age 10.6±3.8 years were investigated. Out of 94 children, 26% had essential hypertension and 74% (30 girls, 40 boys) secondary hypertension. Seven patients (29.2%) with essential hypertension had target organ damage. In this group, hypertension was well controlled with salt and/or calorie restricted diet in 29%, single antihypertensive medicine in 47% and combination therapy in 24%. It was recognised that the main disease in secondary hypertension group were chronic glomerulonephritis in 31.4%, nephropathy due to urinary tract infection in 20%, acute glomerulonephritis in 17.1% and other diseases in 31.5% Target organ damage was detected in 24 (34.2%) patients with secondary hypertension. Blood pressure was under control with single antihypertensive medicine in 50%, various combinations in 44% and nonpharmacologic management in 4%. We concluded that of children with hypertension, 1/4 had primary hypertension, 1/3 with target organ damage was admitted at late stage and in about half of them monotherapy was not sufficient to control the blood pressure.

Keywords:

Antihypertensive Agents, Blood Pressure, Child, Diagnosis, Differential, Hypertension,

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