Abstract 660: Prevalence of Hypertension Among Children with Diabetes Mellitus.

Abstract

This study aims to determine the prevalence of hypertension among children with diabetes mellitus, and describe adherence to the standard of practice regarding early diagnosis and treatment of hypertension in this population. Diabetes renders higher susceptibility to cardiovascular disease in affected patients and thus early detection of hypertension can be beneficial for future quality of life. We hypothesize that a number of diabetic children with hypertension are not promptly diagnosed and treated due to the difficult process preceding diagnosis. This cross-sectional study in an out-patient clinic of a university hospital was based on a group of 263 children (both females and males, age range between 3-18) diagnosed with type 2 diabetes. At the visit, the child's weight and height were recorded, BMI was calculated, systolic and diastolic blood pressure (BP) was taken, and blood sample drawn for hemoglobin A1C (HbA1C) readings. Within the study population we have identified a group of 73 children with hypertension. Comparing the two groups: the normotensive with the hypertensive, we have observed that the normotensive patients have significantly lower average BMI (26.7), p=0.000012 and slightly reduced HbA1C (8.9%), p=0.28 levels compared to the hypertensive group: BMI (32.5) and HbA1C (9.3%), respectively. We investigated the same parameters within every age group starting from age 10, and recorded that HbA1C was only significantly different for the group of 14 year-olds (8.7%; 11.7%, p=0.039). We also found that a significantly higher BMI is linked with hypertension for groups: age 13: BMI (29.2; 33.9, p=0.047), age 14: BMI (24.1; 35.6, p=0.00007) and age 18: BMI (31.8; 45.6, p=0.045). Within the different age groups there were differences between normotensive and hypertensive patients in BMI and HbA1C measurements, but they were not statistically significant and we assume that an increased sample size would be needed to confirm the data. We are currently working on identifying other risk factors including sex, race, height, urine creatinine, urine microalbumin, serum creatinine, lipid profile and thyroid function, that might be responsible for hypertension in pediatric patients with type 2 diabetes.

Prevalence of Hypertension and Albuminuria in Pediatric Type 2 Diabetes

“…Forty-six studies reported hypertension prevalence (Table 1). The reported age at diagnosis of type 2 diabetes ranged from 7.1 to 20.0 years, and the duration of diabetes ranged from inclusion at diagnosis to 7.8 years after diagnosis . While 26 studies (57%) had a cross-sectional design, 13 (28%) were retrospective cohort studies, and 7 (15%) were prospective cohort studies …”

“…4,15,17, The reported age at diagnosis of type 2 diabetes ranged from 7.1 to 20.0 years, 46,47,49,72 and the duration of diabetes ranged from inclusion at diagnosis 40,41,43,51,52,55,56,60,65,66,75,76,81 to 7.8 years after diagnosis. 71 While 26 studies (57%) had a cross-sectional design, 15,17,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][75][76][77][78]82 13 (28%) were retrospective cohort studies, [59][60][61][62]…”

“…Thirty-one studies including 4363 patients with type 2 diabetes reported on the prevalence of hypertension defined as BP in the 95th percentile or greater for age, sex, and height or systolic BP 130 to 140 mm Hg or greater and diastolic BP of 80 to 90 mm Hg or greater. 4,15,17,[40][41][42][43][44][45][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][72][73][74] The…”

“…The included studies had either a low (n = 27) 8,[15][16][17]40,[44][45][46][47][48]50,53,55,56,60,64,65,69,70,72,76,78,79,81,85,89,90 or moderate (n = 33) 4,[41][42][43]49,51,52,54,[57][58][59][61][62][63][66][67][68]71,[73][74][75]77,80,[82][83][84]…”

“…4,8,[40][41][42][43][46][47][48][49][50][51]53,54,[56][57][58][59][60][63][64][65][66][67][68]71,72,74,75,[77][78][79][80]82,83,[85][86][87]89,[91][92][93][94] The sampling frame of some studies was not representative of their target population, 41,42,44,51,52,54,61,63,67,74...…”