Hypertension-associated hospitalizations of children on the increase

By Helen Albert

The number of children hospitalized with hypertension in the USA increased dramatically between 1997 and 2006, with associated increases in healthcare costs, say researchers.

Cheryl Tran (University of Michigan, Ann Arbor, USA) and colleagues used the Healthcare Cost and Utilization Project Kids' Inpatient Database to estimate hospitalizations associated with hypertension in children aged 2-18 years in 1997, 2000, 2003, and 2006.

They found that hypertension-related hospitalizations in this age group almost doubled between 1997 and 2006 from 12,661 to 24,602 cases, respectively.

In addition, inpatient charges for these children increased by 50% between 1997 and 2006 with an estimated overall cost of US$ 3.1 billion (€ 2.5 billion) over this period. The most significant inpatient charge increases were for children with hypertension and end-stage kidney disease.

Whilst increasing hospitalizations for hypertension were expected, the "the economic burden created by inpatient childhood high blood pressure was surprising," commented Tran in a press statement.

The team notes that outpatient charges for these patients are currently unknown, but could increase the overall cost substantially.

Importantly, when compared with other illnesses, the average length of stay for children with hypertension was twice that of other illnesses, at 8 compared with 4 days.

Factors associated with increased risk for hypertension hospitalization included being aged 10-18 years (68% hospitalizations), being male (55% hospitalizations), and being of White ethnicity (48% hospitalizations).

When hypertension was a secondary diagnosis, pneumonia, acute appendicitis, and asthma were the most common primary diagnoses, whereas when hypertension was the primary diagnosis, convulsive disorder, headache, obesity, and systemic lupus erythematosus were the most common secondary diagnoses.

The researchers believe that the increase in childhood obesity may at least partly explain the increase in hypertension-associated hospitalization and emphasize that physicians should strongly recommend healthy lifestyle habits to children and their parents to try and reduce or prevent hypertension.

"A child with high blood pressure is at increased risk for having high blood pressure in adulthood and the heart and stroke risks that come with that diagnosis," said Tran.

Editorialist Joshua Samuels (University of Texas Medical School, Houston, USA) commented: "Given the apparent cost of hypertension even in the pediatric age range, not to mention its whopping cost in adults, now is the time to invest in early detection, prevention, and treatment of elevated blood pressure in children."

He added: "If the current study tells us anything, it is that we cannot afford to wait."

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