Age and gender differences of orthostatic hypertension in children

Abstract

Background: Orthostatic hypotension (OH) is a common orthostatic blood pressure (BP) regulation disorder. Orthostatic hypertension (OHT), on the other hand, is not so common but has relevancy with autonomic neuropathy and diabetes. Orthostatic hypotension is prevalent in females and elderly people. But prevalence of OHT in age and gender is poorly studied. Methods: A retrospective cross-sectional a study was conducted. Data collection was from January 2000 to August 2012. Inclusion criteria were patients referred for syncope of unknown origin, headache, dizziness, chest tightness or sighing. Comparisons were made between males and females and those < 12 and those ≥ 12 years of age. First outcomes included OHT frequency. Secondary outcomes included age and gender differences in head-up tilt test (HUTT) results and its reaction type, the increment of systolic pressure and diastolic pressure at three minutes of HUTT. Results: Out of a total of 2089 children, OHT was noted in 498 cases. Orthostatic hypertension frequency was higher in males (25.93% vs 21.63%, p < 0.05) and those ≥ 12 years of age (20.48% vs 28.05%, p < 0.05). In OHT children, HUTT positive rate was higher in females (48.6% vs 38.1%, p < 0.05) and those ≥ 12 years of age (51.5% vs 33.2%, p < 0.01). No cardiac depression type was noted. The mixed type was more often seen in females (25.2% vs 13.2%, p < 0.05). No significant age and gender differences were noted in systolic and diastolic BP in OHT children within three minutes during HUTT. Conclusions: Orthostatic hypotension in children was more often seen in males and in those aged ≥ 12.