L’ipertensione arteriosa in età pediatrica. Studio di una popolazione scolastica

Most authors fix the upper limits of normal blood pressure at 90th percentile according to age. Nevertheless in their investigation different instruments were used and the often did not relate in detail the position of the subject during the measurement. Other factors, influencing blood pressure values, have been often left out: relation with meals, room temperature, pain, drugs, stress, and so on. The prevalence of hypertension in pediatric age in literature is 0.6-12.4% with several intermediate values. The first very important research concerning the hypertension in pediatric age was carried out by Londe et alii, conducted among 1593 children (785 males and 798 females); they estimated mean values and percentiles according to age and sex. In the present study the authors saw 346 children (161 females and 185 males), 11-15 years old, observed at school, in a comfortable room. Pressure measurement was done twice in the same morning with half an hour interval. Systolic pressure, 4th and 5th Korotkoff tones, was noticed. 11% of the children had systolic pressure values under 50th percentile, 35.3% between 50th and 90th percentile, and 43.1% had values equal to or greater than 90th percentile at the first measurement. The third group went down to 30.6% (106 cases) at the control (after an half an hour). This reduction shows the importance of the emotional factors in the P.A. variations. The 106 children who had systolic and/or diastolic values equal to or greater than 90th percentile were controlled again after a week. 92 children maintained the same values. They were called for the third sitting 1-6 months later. Only 45 subjects agreed our invitation and it was possible to point out that high blood pressure values persisted in 31 children (that is 8.9% of all examined cases). Following correlations were observed: (a) body weight-blood pressure values (either systolic or diastolic ones) and so cutaneous plica-pressure values (p<0.01); (b) moreover, 50% of the 31 hypertensive children had hypertensive parents; (c) the most frequent subjective symptom (13 cases) was cephalalgia. None of the studied school children showed either clinic or biochemical abnormal data, so that it was possible to define their hypertension as “essential”.