Investigation of pediatric hypertension. Use of a tailored protocol
M. R. Ogborn and J. F. Crocker
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Using a comprehensive protocol, the efficacy of simple clinical data,
including history, physical examination, and urinalysis, in the
discrimination of essential or secondary hypertension was investigated by a
review of 103 patients, aged 2 weeks to 18 years, consecutively referred
for investigation. Essential hypertension (55/103 mm Hg) was the most
common diagnosis, even in infancy, whereas various renal disorders formed
the next most common diagnostic category (21/103 mm Hg). Family history and
the presence of "fixed" vs "labile" hypertension were of no value in
detecting secondary hypertension. Urinalysis was useful in detecting
inflammatory renal lesions but not structural disorders of the kidney. This
study emphasizes the need for thorough investigation, including renal
imaging, of asymptomatic hypertensive children and suggests a useful
protocol to achieve this end.
