Prävalenz der arteriellen Hypertonie bei Kindern und Faktoren, die mit arterieller Hypertonie bei Kindern assoziiert sind
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Abstract
Elevated blood pressure in children is an important health issue as elevated blood pressure in children is associated with elevated blood pressure in adults. The extent to which hypertension is diagnosed in German pediatric practices and the frequency with which drug therapy is prescribed is not yet known. Objectives: This dissertation examined the prevalence of hypertension diagnoses in children and adolescents treated in pediatric practices, the factors associated with hypertension in this population, and the prescribing behavior of pediatricians for children and adolescents being treated for primary arterial hypertension. The results were published in two studies. Methods: Data from the IQVIA Disease Analyzer database was used for both studies. This database comprises the electronic medical records of 258 primary care pediatricians in Germany and children and adolescents aged 0-17 years. Patients with a documented initial diagnosis of primary hypertension between January 2005 and December 2023 were included. In the first study, hypertension patients were matched with non-hypertension patients by age and gender in a 1:5 ratio. Conditional multivariate logistic regression models were used to estimate the association between chronic diseases and therapies and the risk of hypertension. In the second study, cumulative prescriptions within the 12-month period prior to the index date for a cohort of 7,482 children and adolescents were analyzed using Kaplan-Meier curves stratified by age group. Multivariate Cox regression was used to examine the association between age, sex, comorbidities, and the probability of receiving treatment. Results: After 1:5 matching, the studies included 7,482 children and adolescents with hypertension and 37,410 control subjects without hypertension. The first study showed an average prevalence of hypertension of 0.12% and an incidence of 1.24 cases per 1000 person-years, both increasing with age. The multivariate regression analysis found a significant positive association between hypertension and ten conditions, including obesity, type 1 diabetes mellitus, dyslipidemia, chronic bronchitis, hypothyroidism, migraine, attention deficit hyperactivity disorder, scoliosis, chronic rhinitis and reaction to severe stress and adjustment disorders. In addition, the prescription of paracetamol was positively associated with the risk of hypertension. The second study showed a low percentage of adolescents, children aged 6 years and older, and children aged 5 years and younger receiving antihypertensive therapy (15.7% in adolescents, 12.8% in children aged 6 years and older, and 10.3% in children aged 5 years and younger). The proportion of those receiving an angiotensin-converting enzyme (ACE) inhibitor, the most commonly prescribed class of medication, was 65.4% 70.3% and 62.8%, respectively, and the proportion of those receiving beta blockers, the second most commonly prescribed class of drugs, was 19.1%, 16.7% and 14.0%, respectively. In the multivariable analysis, co-diagnoses for type 1 diabetes mellitus and epilepsy were significantly correlated with an increased likelihood of receiving antihypertensive therapy. Conclusions: The significant associations between hypertension and chronic diseases, particularly obesity, underscore the need for early prevention strategies. Prospective studies are needed to confirm these associations. Pathophysiological and mechanistic explanations for the associations identified must also be investigated and verified in appropriately designed studies. The low number of children and adolescents with primary hypertension who are prescribed antihypertensive therapy is not in line with current treatment guidelines. This needs to be further investigated.
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Issued: 2026-01-21
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Has part: Moll JC, Bohlken J, Kostev K. Prevalence of and Factors Associated with Hypertension in Children and Adolescents as Observed by German Pediatricians-A Case-Control Study. Children (Basel). 2025 Mar 11;12(3):348. doi: 10.3390/children12030348. PMID: 40150632; PMCID: PMC11940976.Has part: Moll JC, Bohlken J, Weber K, Kostev K. Primary hypertension in German children and adolescents: Low treatment rates and dominance of ACE inhibitors in an analysis of 7,482 cases for the period 2005 to 2023. Int J Clin Pharmacol Ther. 2025 Sep;63(9):405-410. doi: 10.5414/CP204857. PMID: 40599110.
Faculty
FB20:Medizin
Language
de
Keywords
Arterielle HypertonieHypertonieHypertonie bei KindernArterielle Hypertonie bei Kindern
DFG-subjects
2.22-20 - Kinder- und Jugendmedizin
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Moll-von der Wettern, Jacob: Prävalenz der arteriellen Hypertonie bei Kindern und Faktoren, die mit arterieller Hypertonie bei Kindern assoziiert sind. : 2026-01-21. DOI: https://doi.org/10.17192/openumr/539.
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This item has been published with the following license: In Copyright