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>Journals >Acta Pediátrica de México >Year 2014, Issue 3


Castañeda-Aguilar JA, Zaltzman-Girshevich S, Murata C, Espino-Vela J
Treatment of arterial hypertension in children, based on its pathophysiology and on the determination of direct renin in plasma
Acta Pediatr Mex 2014; 35 (3)

Language: Español
References: 29
Page: 190-201
PDF: 671.89 Kb.


Full text




ABSTRACT

Background: The effectiveness of the treatment of arterial hypertension based on the level of renin (Renin-Guided Treatment of Hypertension, RGTH), has been demonstrated in adults. In the pediatric population there is only one retrospective study that suggests the benefit of using this algorithm in children with hypertension.
Objectives: To compare the time needed to control arterial hypertension in two groups of children. One group consisting of patients in which there is a relationship between the clinical diagnosis and plasma renin levels, and the other group without this condition. Also to identify the combination of clinical variables that optimize differential diagnosis of arterial hypertension through a differential model.
Material and methods: A comparative cohort study (observational, prospective and longitudinal) of hypertensive children studied at Instituto Nacional de Pediatría was done. We evaluated the concordance between the clinical diagnosis of the type of hypertension and the results of plasma renin levels. We recorded and compared the time required to normalize blood pressure in two groups of patients: the group of patients with a relationship between the clinical diagnosis and direct renin levels, and another group of patients without this relationship. A selective model was constructed to identify the combination of clinical variables that optimize differential diagnoses for diverse types of hypertension.
Results: There were 34 patients in the group with a relationship between the clinical diagnosis and the renin levels, and 4 in the group without this relation. The median time median to normalize arterial blood pressure in the first group was 3 days (95% CI 2-7) and for the other group was 12.5 days (95% CI 4.5-28). This difference was marginally significant (Log-rank: p=0.064). We obtained a model that discriminates 100% of the time between the 2 types of hypertension through clinical diagnostic variables (medical history and physical examination).
Conclusions: This study suggests the benefit and safety of treatment for hypertensive children using the RGTH algorithm, resulting in a control of hypertension in a shorter period of time.


Key words: Hypertension, children, Renin-Guided Treatment of Hypertension algorithm (RGTH), renin serum test.


REFERENCIAS

  1. World Health Organization. Global Strategy on Diet, Physical Activity and Health. Ginebra (Suiza): WHO; 2010.

  2. Kain J, Corvalán C, Lera L, Galván M, Weisstaub G, Uauy R. Asociación entre el índice de masa corporal y la talla desde el nacimiento hasta los 5 años en preescolares chilenos. Rev Med Chile 2011;139:606-612.

  3. Marrodán M, Mesa M, Alba J, Ambrosio B, Barrio, P, Drak L, Gallardo M, Lermo J, Rosa J, González M. Diagnosis de la obesidad: actualización de criterios y su validez clínica y poblacional. An Pediatr (Barc) 2006;65:5-14.

  4. Solis J. Obesidad en la población pediátrica. Acta Pediatric Costarric 2009;21:86-9.

  5. Lizardo A, Díaz A. Sobrepeso y obesidad infantil. Rev Med Hondur 2011;79:208-13.

  6. Washington R. Evidence-based medicine and the obesogenic environment. J Pediatr 2006;149:5-6.

  7. Haslam D, James W. Obesity. Lancet 2005;366:1197-209.

  8. Braguinsky J. Prevalencia de obesidad en América latina. Anales Sis San Navarra 2002;25:109-115.

  9. Vaillant G, López L, Lozano A. Valores percentiles de peso, talla e índice de masa corporal en escolares argelinos de la Wilaya de Djelfa. MEDISAN 2011;15:1354- 360.

  10. Duncan G, Li S, Zhou X. Prevalence and trends of a metabolic syndrome phenotype among u.s. Adolescents, 1999-2000. Diabetes Care 2004;27:2438-43.

  11. Saland J. Update on the metabolic syndrome in children. Curr Opin Pediatr 2007;19:183-91.

  12. Hernández M, Miguel P, Marrero M, Pérez L, Peña I, Rivas M. Comportamiento de variables clínicas, antropométricas y de laboratorio en pacientes con síndrome metabólico. Medisur 2011;9:22-8.

  13. Álvarez A, González R, Marrero M. Papel de la testosterona y el cortisol en el síndrome metabólico y la diabetes mellitus tipo 2. Rev Cub Endocrin 2010;21:80-90.

  14. Anagnostis P, Athyros V, Tziomalos K, Karagiannis A, Mikhailidis P. The pathogenic role of cortisol in the methabolic síndrome: a hypothesis. J Clin Endocrinol Metab 2009;94:2692-701.

  15. Ramírez E, Valencia M, Bourges H, Espinosa T, Moya S, Salazar G, Alemán H. Body composition prediction equations base don deuterium oxide dilution method in Mexican children: a national study. Eur J Clin Nutr 2012;66:1099- 103.

  16. Aguilar M, González E, García C, García P, Álvarez J, Padilla C, Mur N. Nutr Hosp 2011;27:185-91.

  17. Calle E, Thun M. Petrilli J, Rodríguez C, Heath C. Body mass index and mortality in a perspective cohort of US adults. N Engle J Med 1999;341:1097-105.

  18. Fariñas L, Vásquez V, Martínez A, Carmenate M, Marrodán M. Evaluación del estado nutricional de escolares cubanos y españoles: índice de masa corporal frente a porcentaje grasa. Nutr Clin Diet Hosp 2012;32:58-64.

  19. Arroyo E, Hernández R, Herrera H, Pérez A. Asociación del área grasa y muscular con el índice de masa corporal en niños de dos escuelas rurales, Municipio Hatillo, Edo. Miranda, Venezuela. Interciencia 2008;33:146-51.

  20. González E, Aguilar M, García C, García P, Padilla C, Álvarez J. Estudio epidemiológico de enfermería sobre la prevalencia de sobrepeso, obesidad y su asociación con hipertensión arterial en una población de estudiantes en la ciudad de Granada y su provincia. Nutr Clin Diet Hosp 2010;30:42-50.

  21. Dietz W, Robinson T. Use of body mass index (BMI) as measure of overweight in children and adolescents. J Pediatr 1998;132:191-6.

  22. Kuczmarski R, Ogden C, Grummer L, Flegal K, Guo S, et al. CDC Growth Charts: United States. Adv Data 2000;8:1-27.

  23. Neovius M, Linne Y, Barkeling B, O´Rossner S. Sensitivity and specificity of classification for fatness in adolescents. Am J Clin Nutr 2004;80:597-603.

  24. Batista G, Horta N, Freire Z, Souza G, Machado L, et.al. Índice de masa Corporal presenta buena correlación con el perfil proateroesclerótico en niños y adolescentes. Arq Bras Cardiol 2009;93:256-61.

  25. Eissa M, Dai S, Mihalopoulos N, Day R, Harrist R, Labarthe D. Trajectories of Fat mass Index, Fat Free-Mass Index, and Waist Circumference in Children Project HeartBeat! Am J Prev Med 2009;37:43-9.

  26. Mihanoupulos N, Holubkob R, Young P, Dai S, Labarthe D. Expected Changes in Clinical Measures od Adiposity during Puberty. J Adol Health 2010;47:360-66.

  27. Ramírez E, Valencia M. Tamaño y composición corporal en niños mexicanos I: implicaciones en el uso del BOD, DXA y dilución con deuterio en la evaluación de la masa grasa y masa libre de grasa. RESPYN 2008;9:1-11.

  28. Wells J, Fuller N, Dewit O, Fewtrell M, Elia M, Cole T. Four-component model of body composition in children: density and hydration of fat-free mass and comparision with simpler models. Am J Clin Nutr 1999;69:904-12.

  29. Treuth M, Butte N, Wong W, Ellis K. Body composition in prepubertal girls: comparison of six methods. Int J Ob 2001;25:1352-59.

  30. Jennings G, Bluck L, Wright A, Marinos E. The Use of Infrared Spectrophotometry for Measuring Body Water Spaces. Clin Chem 1999;45:1077-81.

  31. Lohman T. Estimating body composition in children and the elderly, in Advances in Body Composition Assessment. Human Kinetics, Champaign, IL 1992;65-77.

  32. McCarthy H, Cole T, Fry T, Jebb S, Prentice A. Body fat reference curves for children. Int J Obesity 2006;30:598-602.

  33. Szer G, Kovalskys I, De Gregorio M. Prevalencia de sobrepeso, obesidad y su relación con hypertension arterial y centralización del tejido adiposo en escolares. Arch Argent Pediatr 2010;108:492-498.

  34. Salazar G, Rocha M, Mardones F. ¿Es útil la antropometría para estimar la composición corporal en niños preescolares? Rev Chil Pediatr 2003;74:37-45.

  35. Wells J, Fewtrell M, Davis P, Williams J, Coward W, Cole T. Prediction of total body water in infants and children. Arch Dis Child 2005;90:965-71.

  36. Hauroun D, Ewlls J, Williams J, Fuller N, Fewtrell M, Lawson M. Composition of the fat-free mass in obese and nonobese children: matched case-control analyses. Int J Obes 2005;29:29-36.

  37. Kenneth J, Manjiang Y, Shypailo R, Urlando A, Wong W, Heird W. Body composition assessment in infancy: airdisplacement plethysmography compared with a reference 4-compartment model. Am J Clin Nutr 2007;85:90-95.

  38. Westrate J, Deurenberg P. Body composition in children: proposal for a method for calculating body fat percentage from total body density or skinfold thickness measurement. Am J Clin Nutr 1989;50:1104-15.

  39. Gately P, Radley D, Cooke C, Carrol S, Oldroyd B, Truscott J, W Coward, Wright A. Comparison of body composition methods in overweight and obese children. J Appl Physiol 2003;95:2039-46.

  40. Arciniega S. Definición y criterios de obesidad. Nutr Clin 2002;5:236-40.






>Journals >Acta Pediátrica de México >Year 2014, Issue 3
 

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