Burden of Hypertension and Abnormal Glomerular Permeability in Hypertensive School Children

BACKGROUND: Childhood hypertension has been associated with target-organ damage in young adults. It is often asymptomatic in both children and adolescents; when persistent, and long-standing, it could be a significant risk factor for kidney damage and increased glomerular permeability. OBJECTIVES: Burden of hypertension and its impact on glomerular permeability were prospectively determined in randomly recruited primary school children. PATIENTS AND METHODS: Blood pressure (BP) measurement was performed by the auscultation method, and abnormal glomerular permeability was assessed by dipstick testing of urine for persistent proteinuria and/or hematuria for ≥ three months in hypertensive children. RESULTS: Of 1,335 pupils aged 10.0 ± 2.4 (6.0 - 14.0) years, 33 (2.5%) were hypertensive. Overall mean systolic/diastolic BP was 125.6 ± 6.5/81.7 ± 3.3 (range: 114.0 - 140.0/80.0 - 90.0) mmHg. Nine (27.3%) had combined systolic and diastolic hypertension, 126.7 ± 5.7/80.0 - 80.0 ± 0.0 (120.0 - 130.0/80.0 - 80.0) mmHg. Isolated systolic hypertension, 125.4 ± 6.7 (114.0 - 140.0) mmHg, was present in 14 (42.4%), whereas 10 (30.3%) had isolated diastolic hypertension, 82.0 ± 3.5 (80.0 - 90.0) mmHg. Mean systolic and diastolic BP were 131.0 ± 3.3 (130.0 - 140.0) mmHg and 86.5 ± 4.43 (80.0 - 90.0) mmHg, respectively. According to the dipstick test, none of the hypertensive pupils showed urinalysis evidence of proteinuria and/or hematuria after three months of testing. CONCLUSIONS: Although the burden of hypertension was 2.5%, the dipstick method did not detect any hypertension-related abnormal glomerular permeability in the school children.