Hypertension in Thai children: a report from a hospital in suburban area.

Hypertension in children is the major risk for cardiovascular disease in adult. Limited data are available for hypertension in children in Southeast Asia. To determine the cause, treatment, and long-term outcome of hypertension in Thai Children, the authors retrospectively studied 62 patients (age <15 years) diagnosed with hypertension at Thammasat University hospital, from December 01, 2004 through November 30, 2009. The mean age was 9.2 +/- 4.2 years; median follow-up 8 months. Fifty five (88.7%) patients had secondary hypertension. Patients presented with stage 2 hypertension (67.7%), and hypertensive emergency (9.7%). Renal parenchymal disease caused 67.3% of secondary hypertension. End organ damage included left ventricular hypertrophy (11.3%) and hypertensive retinopathy (6.4%). Hypertensive emergency was caused mostly by acute poststreptococcal glmoerulnephritis (APSGN, 66.7%). Intravenous diuretic coupled with oral antihypertensive drugs gave uncontrolled blood pressure in APSGN with hypertensive emergency. Seventy percents of patients with essential hypertension had obesity. Majority of the patients had controlled hypertension without medication. Acute poststreptococcal glomerulonephritis remained the common cause of transient hypertension and hypertensive emergency in Thai children. The high incidence of obesity among essential hypertension in children demonstrated in the present study should alert Thai pediatrician to measure blood pressure in every obese child. Treatment of childhood hypertension was associated with good long-term outcome.