Joongyub Lee1,2, Seung-Ki Kim3, Hee Gyung Kang4, Il-Soo Ha4, Kyu-Chang Wang3, Ji Yeoun Lee3,5, Ji Hoon Phi3. 1. 1Department of Prevention and Management, Inha University Hospital, School of Medicine, Inha University. 2. 2Incheon Regional Cardiocerebrovascular Disease Center, Incheon. 3. 3Division of Pediatric Neurosurgery and. 4. 4Department of Pediatrics, Seoul National University Children's Hospital; and. 5. 5Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: Although an association between moyamoya disease (MMD) and renovascular hypertension has been acknowledged, the literature on systemic hypertension without renal artery stenosis among patients with MMD is scarce. The authors aimed to evaluate the prevalence and risk factors of hypertension using data from MMD patients who visited an outpatient clinic of a pediatric neurosurgical department in 2016. METHODS: The authors evaluated the blood pressure (BP) of pediatric MMD patients at their postsurgical appointment following the American Academy of Pediatrics clinical practice guideline on high BP, in which hypertension was defined as BP measurements higher than the value of age-, sex-, and height-specific 95th percentile of the general population from at least 3 separate visits. Growth of patients was determined using 2017 Korean National Growth Charts for children and adolescents. The cutoff value of the 95th percentile of BP was determined by referring to normative BP tables of Korean children and adolescents. A logistic regression model was used to assess the associations between patients' clinical characteristics and prevalent hypertension. RESULTS: In total, 131 surgically treated pediatric MMD patients were included, of whom 38.9% were male and the median age at diagnosis was 8.0 years (range 1.2-15.0 years). The definition of hypertension was met in 38 patients, with a prevalence of 29.0% (95% CI 21.2%-36.8%). A tendency was observed for a higher prevalence of hypertension in male patients (31.4%), in patients with posterior cerebral artery (PCA) involvement (47.8%), and in cases in which infarction was shown on initial MRI (37.3%). Age at diagnosis (adjusted OR [aOR] 0.82, 95% CI 0.70-0.97), PCA involvement (aOR 3.81, 95% CI 1.29-11.23), body mass index (aOR 1.30, 95% CI 1.13-1.51), and years of follow-up since surgery (aOR 0.80, 95% CI 0.68-0.94) were related to systemic hypertension. CONCLUSIONS: A high prevalence of hypertension was demonstrated in pediatric MMD patients. Therefore, adequate attention should be paid to reduce BP and prevent subsequent events.
OBJECTIVE: Although an association between moyamoya disease (MMD) and renovascular hypertension has been acknowledged, the literature on systemic hypertension without renal artery stenosis among patients with MMD is scarce. The authors aimed to evaluate the prevalence and risk factors of hypertension using data from MMDpatients who visited an outpatient clinic of a pediatric neurosurgical department in 2016. METHODS: The authors evaluated the blood pressure (BP) of pediatric MMDpatients at their postsurgical appointment following the American Academy of Pediatrics clinical practice guideline on high BP, in which hypertension was defined as BP measurements higher than the value of age-, sex-, and height-specific 95th percentile of the general population from at least 3 separate visits. Growth of patients was determined using 2017 Korean National Growth Charts for children and adolescents. The cutoff value of the 95th percentile of BP was determined by referring to normative BP tables of Korean children and adolescents. A logistic regression model was used to assess the associations between patients' clinical characteristics and prevalent hypertension. RESULTS: In total, 131 surgically treated pediatric MMDpatients were included, of whom 38.9% were male and the median age at diagnosis was 8.0 years (range 1.2-15.0 years). The definition of hypertension was met in 38 patients, with a prevalence of 29.0% (95% CI 21.2%-36.8%). A tendency was observed for a higher prevalence of hypertension in male patients (31.4%), in patients with posterior cerebral artery (PCA) involvement (47.8%), and in cases in which infarction was shown on initial MRI (37.3%). Age at diagnosis (adjusted OR [aOR] 0.82, 95% CI 0.70-0.97), PCA involvement (aOR 3.81, 95% CI 1.29-11.23), body mass index (aOR 1.30, 95% CI 1.13-1.51), and years of follow-up since surgery (aOR 0.80, 95% CI 0.68-0.94) were related to systemic hypertension. CONCLUSIONS: A high prevalence of hypertension was demonstrated in pediatric MMDpatients. Therefore, adequate attention should be paid to reduce BP and prevent subsequent events.
Entities:
Keywords:
BMI = body mass index; BP = blood pressure; MMD = moyamoya disease; PCA = posterior cerebral artery; RAS = renal artery stenosis; TIA = transient ischemic attack; aOR = adjusted OR; hypertension; moyamoya disease; prevalence; vascular disorders
Authors: Cori Xiu Yue Sutton; Enrique Carrazana; Catherine Mitchell; Jason Viereck; Kore Kai Liow; Arash Ghaffari-Rafi Journal: Ann Med Surg (Lond) Date: 2022-05-11