ECE2019 ePoster Presentations Diabetes, Obesity and Metabolism (42 abstracts)
Characterization of essential hypertension vs secondary hypertension in late childhood and adolescence: Experience in an outpatient hypertension clinic
Paula Maria Fernandez-Trujillo-Comenge 1 , Agnieszka Kuzior 1 , Manuel Esteban Nivelo-Rivadeneira 1 , Carmen Acosta-Calero 1 , Ana Delia Santana Suarez 1 , Victoria Sainz de Aja-Curbelo 2 , Raquel Rodriguez Medina 3 & Francisco Javier Martinez-Martin 4
1Endocrinology and Nutrition Dpt, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain; 2Barrio Atlantico Primary Healthcare Center, Las Palmas de Gran Canaria, Spain; 3Guanarteme Primary Healthcare Center, Las Palmas de Gran Canaria, Spain; 4Outpatient Hypertension Clinic, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain.
Aim: Description of the differences between patients diagnosed of essential (EH) vs. secondary (SH) hypertension in our Outpatient Hypertension Clinic.
Methods: Review of the Clinical Records and of the relevant literature. Comparisons were made by non-paired t-test in continuous variables and Fisher’s exact test in discrete variables.
Results: From 1994 to 2018, 49 patients < 20 years old were referred to our (mostly adult) Clinic for hypertension workup and treatment; 22 (45%) were diagnosed of SH, (16 primary aldosteronism, 2 glomerulonephritis, 2 arterial renal dysplasia, 1 paraganglioma, 1 aortic coarctation), and 27 (55%) of EH by exclusion.
Gender: 13 female, 9 male (SH); 11 female, 16 male (EH); P=0.2563
Age (years): 14.9+3.2 (SH); 16.1+2.5 (EH); P=0.1471
BMI (Kg/m2): 18.9+2.4 (SH); 27.8+8.4 (EH); P < 0.0001
SH group: 2 people overweight, none obese; EH group 14 overweight, 8 obese (3 morbidly); P < 0.0001 for overweight + obesity, P=0.0056 for obesity, P=0.2423 for morbid obesity.
Prediabetes: 1 (SH); 6 (EH); Diabetes: None (SH); 1 T1DM +4 T2DM (EH); P < 0.0001 for dysglycemia, P=0.0561 for DM.
Fasting glucose (mg/dL): 79+8 (SH); 98+15 (EH); P < 0.0001
HbA1C (%): 4.9+0.4 (SH); 5.8+0.5 (EH); P < 0.0001
HOMA2: 2.5+0.4 (SH); 4.6+1.8 (EH); P < 0.0001
eGFR (ml/min/1.73 m2): 78.6+15.4 (SH); 102.0+31.4 (EH); P < 0.0025
Total cholesterol (mg/dL): 168+15 (SH); 216+31 (EH); P < 0.0001
HDL-cholesterol (mg/dL): 55+7 (SH); 36+9 (EH); P < 0.0001
LDL-cholesterol (mg/dL): 89+9 (SH); 133+21 (EH); P < 0.0001
Triglycerides (mg/dL): 118+5 (SH); 234+106 (EH); P < 0.0001
AST (IU/L): 23+6 (SH); 38+9 (EH); P < 0.0001
ALT(IU/L): 18+5 (SH); 35+8 (EH); P < 0.0001
GGT (IU/L): 29+4 (SH); 67+15 (EH); P < 0.0001
PCR (mg/L): 0.4+0.1 (SH); 2.8+1.2 (EH); P < 0.0001
Target organ damage: 6 low eFGR +3 CVD (SH); 1 low eGFR (EH); P=0.0027 (globally), P=0.0946 (low eGFR).
Conclusions: Near half of the hypertensive patients in this age group had SH, mostly primary aldosteronism, emphasizing that hypertension in this age group requires diagnostic workup. EH in this age group is associated with the ‘metabolic syndrome’ profile, with overweight and obesity, dysglycemia, dislipidemia, liver enzyme profile suggesting steatosis, and low-grade chronic inflammation. The prevalence of target organ damage was higher in the SH group.
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Endocrine Abstracts
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