Health-related quality of life in paediatric arterial hypertension: a cross-sectional study

Abstract

BackgroundThe prevalence of paediatric hypertension is increasing worldwide, especially due to the childhood obesity epidemic, and is an important public-health concern. While the Health-Related Quality of Life (HRQoL) was already shown to be impaired in the adult hypertensive population, a scarcity of data still exists on HRQoL in paediatric hypertensive patients. Our purpose was thus to assess the HRQoL of children and adolescents with arterial hypertension, using self- and proxy-reports, and to determine the correlations between child and parent questionnaire scores.MethodsThe Paediatric Quality of Life Inventory™ 4.0 Generic Core Scales were administered via post to children and adolescents, aged 5-18 years, with primary or secondary arterial hypertension and parents as proxy-reports. Patients were recruited from a paediatric nephrology unit in a tertiary hospital, using an out-patient clinic visit registry. Healthy school children and adolescents from a local primary school, aged 6 to 15 years, and their parents formed the control group. HRQoL group comparisons were calculated with independent samples t-test and child-parent correlations with the Pearson’s r correlation coefficient.ResultsIn total we recruited 139 patient and 199 control group participants as self- and proxy-reports. Scores from self- as well as proxy-reports indicated a significantly lower overall HRQoL in the paediatric hypertensive population (95% CI for mean score difference: − 11.02, − 2.86 for self- and − 10.28, − 2.67 for proxy-reports; p = .001). In self-reports, lower physical (95% CI: -13.95, − 4.89; p = <.001), emotional (95% CI: -12.96, − 2.38; p = .005), school (95% CI: -11.30, − 0.42; p = .035), and psychosocial functioning scores were observed (95% CI: -10.34, − 1.89; p = .005). Parent proxy-reports were lower in physical (95% CI: -14.31, − 5.39; p = <.001), emotional (95% CI: -12.39, − 2.60; p = .003) and psychosocial scores (95% CI: -9.36, − 1.34; p = .009). Pearson’s r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p < .001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p < .001).ConclusionsThis cross-sectional study gives insight into the detrimental impact of hypertension on children’s and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients’ physical and psychosocial well-being throughout their development.

Health-related quality of life in pediatric patients with high-normal blood pressure and primary arterial hypertension

“…Our results from the questioning of children with normal BP in general terms are consistent with data from other studies. The Total Score HRQoL for healthy schoolchildren, according to different authors, ranges from 72.7 to 86.9 points [21][22][23][24]. In our study, the Total Score HRQoL in the control group was 79.05 [12.25].…”

“…In contrast, data reported by Petek et al [24] showed that high BP was associated with good HRQoL parameters in children and adolescents [25], including those with high BP due to chronic kidney disease [26].…”

A Shift of the Parameters of the Cardiovascular System in Adolescents during the Period from 2004 to 2020 as a Result of Modification of Educational Environment

“…It is important to remember that the changes in the functional state of the BP regulation systems observed in our study, not only depend on psycho-emotional stress, but can also produce a negative impact on the health of schoolchildren in general, thus closing a "vicious circle". It is known that hypertension is perceived at the subjective level as feeling bad and negative mood that reduces the quality of social life of adolescents [34]. Objective studies have shown that adolescents with high BP demonstrated lower effectiveness in cognitive tests [35].…”

Gender characteristics of health-related quality of life indicators in children with high normal blood pressure and primary hypertension

“…Сучасні наукові бази даних мають обмежену кількість робіт, присвячених вивченню HRQoL у дітей з АГ і високим нормальним АТ. У більшості з них не використовували дані АМАТ, а діагностику АГ проводили за офісним вимірюванням АТ, що, на наш погляд, не дозволяє чітко розмежувати дітей з високим нормальним АТ і початковими етапами розвитку АГ.Зокрема, у дослідженні, проведеному в Словенії[20], не враховували ступінь підвищення АТ. У статті вказується, що при лікуванні більшості пацієнтів використовувалась лише модифікація способу життя, це дозволяє припустити, що ступінь підвищення АТ був незначним.…”

“…Як і в дослідженнях, проведених у Словенії, у нашій роботі найменша кількість балів у дітей з АГ була отримана за шкалою емоційного функціонування. Підвищений рівень АТ не вплинув на рівень соціального функціонування як у нашій, так і в указаній роботі.На відміну від даних, що повідомляли Petek et al[20], в інших дослідженнях було встановлено, що високий показник АТ пов'язаний з добрим HRQoL у дітей[21].У дослідженні A. Berendes et al [21] брали участь 7697 пацієнтів віком від 11 до 17 років. Основним висновком цього дослідження було те, що підлітки з підвищеним АТ виявили значно кращі показники якості життя і нижчий рівень дистресу.…”