Araştırma Makalesi
BibTex RIS Kaynak Göster

Clinical and laboratory characteristics of pediatric orthostatic hypertension: a retrospective study

Yıl 2025, Cilt: 7 Sayı: 3, 338 - 342, 30.05.2025
https://doi.org/10.38053/acmj.1659477

Öz

Aims: Orthostatic hypertension (OHT) is an underrecognized condition in the pediatric population, characterized by an abnormal rise in blood pressure upon standing. Given its potential long-term implications, including cardiovascular remodeling and end-organ damage, early identification and management of OHT are crucial. This study aims to evaluate the clinical and laboratory characteristics of children diagnosed with OHT, providing insights into potential risk factors and associated conditions.
Methods: A retrospective, cross-sectional study was conducted at Ankara Training and Research Hospital between September 2022 and August 2024. A total of 111 pediatric patients diagnosed with OHT based on an active standing test were included. Demographic data, presenting symptoms, laboratory parameters (including vitamin B12, ferritin, and vitamin D levels) were analyzed.
Results: The median age of the cohort was 15.3 years (range: 6.8–17.9), with a female predominance (63%). Nearly half of the patients (46%) were overweight or obese, and 22% had a family history of hypertension. Cardiovascular symptoms were the most common (36%), followed by cerebral hypoperfusion symptoms (35%) and other symptoms, including fatigue and concentration issues (27%). A significant proportion of the patients exhibited vitamin D deficiency (41%), vitamin B12 borderline levels (45%), and iron deficiency anemia (15%). Additionally, postural orthostatic tachycardia syndrome (POTS) was present in 24% of patients, with a notable association between POTS and low body weight (p=0.037).
Conclusion: The descriptive findings of this study illustrate a range of clinical and laboratory characteristics in children with OHT, hinting at potential areas for future investigation. Although associations with pubertal status, obesity, and vitamin deficiencies were observed, the study's design limits causal inference. Future research, including control groups and prospective approaches, is crucial to understand the clinical importance of these observations.

Kaynakça

  • Magkas N, Tsioufis C, Thomopoulos C, et al. Orthostatic hypotension: from pathophysiology to clinical applications and therapeutic considerations. J Clin Hypertens (Greenwich). 2019;21(5):546-554. doi: 10.1111/jch.13521
  • Zhang Q, Li J, Xie Y, Zhao J, Du J. Orthostatic hypertension in children and adolescents with postural tachycardia syndrome. J Trop Pediatr. 2014;60(6):461-466. doi:10.1093/tropej/fmu055
  • Duan H, Zhou K, Hua Y. Clinical progress of orthostatic hypertension in children. Chin Med J (Engl). 2014;127(21):3825-3828. doi:10.3760/cma.j.issn.0366-6999.20132969
  • Zhao J, Han Z, Zhang X, et al. A cross-sectional study on upright heart rate and BP changing characteristics: basic data for establishing diagnosis of postural orthostatic tachycardia syndrome and orthostatic hypertension. BMJ Open. 2015;5(6):e007356. doi:10.1136/bmjopen-2014-007356
  • Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. doi:10.1542/peds.2017-1904
  • Wang C, Li Y, Liao Y, et al. 2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents. Sci Bull (Beijing). 2018;63(23):1558-1564. doi:10.1016/j.scib.2018.09.019
  • Misra M, Pacaud D, Petryk A, et al. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417. doi:10.1542/peds.2007-1894
  • Aksu T, Ünal Ş. Iron deficiency anemia in infancy, childhood, and adolescence. Turk Arch Pediatr. 2023;58(4):358-362. doi:10.5152/TurkArchPediatr.2023.23049
  • Hu Y, Jin H, Du J. Orthostatic hypertension in children: an update. Front Pediatr. 2020;8:425. doi:10.3389/fped.2020.00425
  • Hu Y, Wang Y, He B, et al. Sympathetic overactivation from supine to upright is associated with orthostatic hypertension in children and adolescents. Front Pediatr. 2020;8:54. doi: 10.3389/fped.2020.00054
  • Khalaji A, Behnoush AH, Tajdini M. Association between vitamin D deficiency and vasovagal syncope: a systematic review and meta-analysis. Clin Cardiol. 2023;46(7):721-728. doi:10.1002/clc.24035
  • Kovalchuk T, Boyarchuk O. Serum vitamin D levels in children and adolescents with vasovagal syncope, syncope due to orthostatic hypotension, and cardiac syncope. Turk Arch Pediatr. 2023;58(1):42-48. doi:10.5152/TurkArchPediatr.2022.22141
  • Xiao Y, Wu J, Min L, Dong X. The correlation between serum 25-hydroxyvitamin D and parathyroid hormone levels and orthostatic intolerance in children. Progress Pediatr Cardiol. 2022;66:101550. doi:10. 1016/j.ppedcard.2022.101550
  • Zhang Q, Sun Y, Zhang C, Qi J, Du J. Vitamin D deficiency and vasovagal syncope in children and adolescents. Front Pediatr. 2021;9:575923. doi: 10.3389/fped.2021.575923
  • Oden Akman A, Tumer L, Hasanoglu A, Ilhan M, Caycı B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int. 2011;53(6):968-973. doi:10.1111/j.1442-200X. 2011.03486.x
  • Beitzke M, Pfister P, Fortin J, Skrabal F. Autonomic dysfunction and hemodynamics in vitamin B12 deficiency. Auton Neurosci. 2002;97(1): 45-54. doi:10.1016/s1566-0702(01)00393-9
  • Gröber U, Kisters K, Schmidt J. Neuroenhancement with vitamin B12—underestimated neurological significance. Nutrients. 2013;5(12):5031-5045. doi:10.3390/nu5125031
  • Aytemir K, Aksöyek S, Büyükasik Y, et al. Assessment of autonomic nervous system functions in patients with vitamin B12 deficiency by power spectral analysis of heart rate variability. Pacing Clin Electrophysiol. 2000;23(6):975-978. doi:10.1111/j.1540-8159.2000.tb00883.x
  • Öner T, Guven B, Tavli V, Mese T, Yılmazer MM, Demirpence S. Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics. 2014;133(1):e138-e142. doi:10.1542/peds.2012-3427
  • Pektas A, Koken R, Koca HB. Serum vitamin B-12 in children presenting with vasovagal syncope. Asia Pac J Clin Nutr. 2018;27(1):176-181. doi:10.6133/apjcn.022017.17
  • Zhao J, Yang JY, Jin HF, Du JB. Clinical analysis of orthostatic hypertension in children. Zhonghua Er Ke Za Zhi. 2012;50(11):839-842.
  • Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019;285(4):352-366. doi:10.1111/joim.12852
  • Sebastian SA, Co EL, Panthangi V, et al. Postural orthostatic tachycardia syndrome (POTS): an update for clinical practice. Curr Probl Cardiol. 2022;47(12):101384. doi:10.1016/j.cpcardiol.2022.101384
Yıl 2025, Cilt: 7 Sayı: 3, 338 - 342, 30.05.2025
https://doi.org/10.38053/acmj.1659477

Öz

Kaynakça

  • Magkas N, Tsioufis C, Thomopoulos C, et al. Orthostatic hypotension: from pathophysiology to clinical applications and therapeutic considerations. J Clin Hypertens (Greenwich). 2019;21(5):546-554. doi: 10.1111/jch.13521
  • Zhang Q, Li J, Xie Y, Zhao J, Du J. Orthostatic hypertension in children and adolescents with postural tachycardia syndrome. J Trop Pediatr. 2014;60(6):461-466. doi:10.1093/tropej/fmu055
  • Duan H, Zhou K, Hua Y. Clinical progress of orthostatic hypertension in children. Chin Med J (Engl). 2014;127(21):3825-3828. doi:10.3760/cma.j.issn.0366-6999.20132969
  • Zhao J, Han Z, Zhang X, et al. A cross-sectional study on upright heart rate and BP changing characteristics: basic data for establishing diagnosis of postural orthostatic tachycardia syndrome and orthostatic hypertension. BMJ Open. 2015;5(6):e007356. doi:10.1136/bmjopen-2014-007356
  • Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. doi:10.1542/peds.2017-1904
  • Wang C, Li Y, Liao Y, et al. 2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents. Sci Bull (Beijing). 2018;63(23):1558-1564. doi:10.1016/j.scib.2018.09.019
  • Misra M, Pacaud D, Petryk A, et al. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417. doi:10.1542/peds.2007-1894
  • Aksu T, Ünal Ş. Iron deficiency anemia in infancy, childhood, and adolescence. Turk Arch Pediatr. 2023;58(4):358-362. doi:10.5152/TurkArchPediatr.2023.23049
  • Hu Y, Jin H, Du J. Orthostatic hypertension in children: an update. Front Pediatr. 2020;8:425. doi:10.3389/fped.2020.00425
  • Hu Y, Wang Y, He B, et al. Sympathetic overactivation from supine to upright is associated with orthostatic hypertension in children and adolescents. Front Pediatr. 2020;8:54. doi: 10.3389/fped.2020.00054
  • Khalaji A, Behnoush AH, Tajdini M. Association between vitamin D deficiency and vasovagal syncope: a systematic review and meta-analysis. Clin Cardiol. 2023;46(7):721-728. doi:10.1002/clc.24035
  • Kovalchuk T, Boyarchuk O. Serum vitamin D levels in children and adolescents with vasovagal syncope, syncope due to orthostatic hypotension, and cardiac syncope. Turk Arch Pediatr. 2023;58(1):42-48. doi:10.5152/TurkArchPediatr.2022.22141
  • Xiao Y, Wu J, Min L, Dong X. The correlation between serum 25-hydroxyvitamin D and parathyroid hormone levels and orthostatic intolerance in children. Progress Pediatr Cardiol. 2022;66:101550. doi:10. 1016/j.ppedcard.2022.101550
  • Zhang Q, Sun Y, Zhang C, Qi J, Du J. Vitamin D deficiency and vasovagal syncope in children and adolescents. Front Pediatr. 2021;9:575923. doi: 10.3389/fped.2021.575923
  • Oden Akman A, Tumer L, Hasanoglu A, Ilhan M, Caycı B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int. 2011;53(6):968-973. doi:10.1111/j.1442-200X. 2011.03486.x
  • Beitzke M, Pfister P, Fortin J, Skrabal F. Autonomic dysfunction and hemodynamics in vitamin B12 deficiency. Auton Neurosci. 2002;97(1): 45-54. doi:10.1016/s1566-0702(01)00393-9
  • Gröber U, Kisters K, Schmidt J. Neuroenhancement with vitamin B12—underestimated neurological significance. Nutrients. 2013;5(12):5031-5045. doi:10.3390/nu5125031
  • Aytemir K, Aksöyek S, Büyükasik Y, et al. Assessment of autonomic nervous system functions in patients with vitamin B12 deficiency by power spectral analysis of heart rate variability. Pacing Clin Electrophysiol. 2000;23(6):975-978. doi:10.1111/j.1540-8159.2000.tb00883.x
  • Öner T, Guven B, Tavli V, Mese T, Yılmazer MM, Demirpence S. Postural orthostatic tachycardia syndrome (POTS) and vitamin B12 deficiency in adolescents. Pediatrics. 2014;133(1):e138-e142. doi:10.1542/peds.2012-3427
  • Pektas A, Koken R, Koca HB. Serum vitamin B-12 in children presenting with vasovagal syncope. Asia Pac J Clin Nutr. 2018;27(1):176-181. doi:10.6133/apjcn.022017.17
  • Zhao J, Yang JY, Jin HF, Du JB. Clinical analysis of orthostatic hypertension in children. Zhonghua Er Ke Za Zhi. 2012;50(11):839-842.
  • Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019;285(4):352-366. doi:10.1111/joim.12852
  • Sebastian SA, Co EL, Panthangi V, et al. Postural orthostatic tachycardia syndrome (POTS): an update for clinical practice. Curr Probl Cardiol. 2022;47(12):101384. doi:10.1016/j.cpcardiol.2022.101384
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji
Bölüm Research Articles
Yazarlar

Yasemin Nuran Dönmez 0000-0002-4689-5888

Berkay Celep 0009-0005-0859-9307

Demet Baltu 0000-0002-2681-4905

Yusuf Ziya Şener 0000-0001-5151-5133

Yayımlanma Tarihi 30 Mayıs 2025
Gönderilme Tarihi 18 Mart 2025
Kabul Tarihi 12 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 7 Sayı: 3

Kaynak Göster

AMA Dönmez YN, Celep B, Baltu D, Şener YZ. Clinical and laboratory characteristics of pediatric orthostatic hypertension: a retrospective study. Anatolian Curr Med J / ACMJ / acmj. Mayıs 2025;7(3):338-342. doi:10.38053/acmj.1659477

Üniversitelerarası Kurul (ÜAK) Eşdeğerliği: Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN]

-  Dahil olduğumuz İndeksler (Dizinler) ve Platformlar sayfanın en altındadır.

Not: Dergimiz WOS indeksli değildir ve bu nedenle Q olarak sınıflandırılmamaktadır.

Yüksek Öğretim Kurumu (YÖK) kriterlerine göre yağmacı/şüpheli dergiler hakkındaki kararları ile yazar aydınlatma metni ve dergi ücretlendirme politikasını tarayıcınızdan indirebilirsiniz. https://dergipark.org.tr/tr/journal/3449/page/10809/update 

Dergi Dizin ve Platformları

TR Dizin ULAKBİM, Google Scholar, Crossref, Worldcat (OCLC), DRJI, EuroPub, OpenAIRE, Turkiye Citation Index, Turk Medline, ROAD, ICI World of Journal's, Index Copernicus, ASOS Index, General Impact Factor, Scilit.