Studies on preventive nephrology: Systemic hypertension in the pediatric and adolescent population of Gassim, Saudi Arabia

Ann Saudi Med. 1997 Jan;17(1):47-52. doi: 10.5144/0256-4947.1997.47.

Abstract

Casual blood pressure was recorded for subjects of Faizia East Primary Health District during a cross-sectional population survey. Valid information was obtained from 5671 subjects, out of which 3299 (1561 males and 1738 females) were between the ages of three and 18, constituting therefore the pediatric/adolescent (P/A) sector of our study population. The prevalence of hypertension (HPN), defined as A(3) 95th percentile for total HPN population (mild and severe) and A(3) 99th percentile for severe, was calculated for the three-year age cohorts suggested by the Task Force on Blood Pressure Control in Children (1987). The three subsets of HPN were derived from the suggested cut-off levels without any modifications. Overall prevalence of HPN was, for the P/A, found to be 10.65% (351/3299). Females in all the age cohorts were significantly more hypertensive than males, overall gender prevalence being 7.94% (124/1561) for males against 13.06% (227/1738) for females: P=0.0000019; CI: 0.45<OR7lt;0.73. One hundred and twenty-eight subjects (3.88%) had severe HPN, again with gender difference in favor of females (2.57 versus 5.06%), P=0.00022; CI: 0.33<OR<0.74). Sixty-seven and a half percent (237/351) of the HPN population were in the six to 12 year age group, with the significant gender difference persisting (P=0.000407; CI: 0.41<OR<0.74). Ninety-four of these (73.44%) had the severe HPN, with similarly significant gender difference (P=0.0018; CI: 0.31<OR<0.79). Significantly, 67% of gross proteinuria for the entire population has been found in the same age cohort with the same significant gender difference. ISHPN was found to constitute 51.57% (181/351) of the HPN population, followed by IDHPN with 32.48% (114/351) and S/DHPN the least with 15.95% (56/351). The significant gender difference in favor of females noted seems to be unique to the Saudi population. Similarly, the preponderance of ISHPN subsets is, to our knowledge, being recorded from the first time in literature. When coupled with the pattern of proteinuria, we believe that, in the context of preventive nephrology, greater attention will need to be devoted to the pediatric population, especially females.