Young Adults with Spina Bifida May Have Higher Occurrence of Prehypertension and Hypertension.

Stepanczuk BC, Dicianno BE, Webb TS. (2013) Young Adults with Spina Bifida May Have Higher Occurrence of Prehypertension and Hypertension.  American Journal of Physical Medicine & Rehabilitation. 2013 Oct 1. 

Abstract

OBJECTIVE:

The aims of this study were to determine the occurrence of prehypertension and high blood pressure in adults with spina bifida (SB) and to examine relationships among blood pressure, cardiovascular disease risk factors, and SB-specific factors.

DESIGN:

This is a cross-sectional, retrospective analysis of adults with SB. SB-specific factors and cardiovascular disease risk factors were compared among subjects with high blood pressure, subjects with blood pressure in the prehypertensive range, and normotensive subjects using the χ, Kruskal-Wallis, or Fisher's exact tests.

RESULTS:

Of 225 subjects, the occurrence of prehypertension and high blood pressure was 27% (n = 22) and 27% (n = 22) for ages 18-29 yrs, 35% (n = 26) and 41% (n = 30) for ages 30-39 yrs, 18% (n = 8) and 66% (n = 29) for ages 40-49 yrs, and 21% (n = 5) and 67% (n = 16) for 50 yrs or older, respectively. Of the subjects with high blood pressure, 56% were men, 14% had obstructive sleep apnea, 14% had diabetes, 19% had renal dysfunction, 38% used tobacco, 16% had hydronephrosis, and 71% had a shunt. The groups differed significantly with respect to diabetes (P = 0.004), bladder procedures (P = 0.001), and renal dysfunction (P < 0.001), with higher proportions of subjects with high blood pressure having these comorbidities.

CONCLUSIONS:

Fewer than half of the subjects were considered normotensive. A greater proportion of young adults with SB appear to have high blood pressure compared with the general United States population. Because elevated blood pressure is an independent, modifiable risk factor of cardiovascular disease, these findings support early screening and intervention for elevated blood pressure in individuals with SB.

The Prevalence of Hypertension in Children with Spina Bifida

Mazur L, Lacy B, Wilsford L. (2011) The Prevalence of Hypertension in Children with Spina Bifida Acta Paediatr. 2011 Aug;100(8):e80-3.



AIM:
To determine whether children with spina bifida (SB) have a higher prevalence of hypertension (HTN) than population-based controls.


METHODS:
Charts of all patients (n=123) seen in the Spina Bifida Clinic at Shriners Hospital in Houston, Texas, were reviewed for age, gender, ethnicity, type and level of neural tube defect, height, weight and blood pressure (BP). HTN was defined as a systolic blood pressure or diastolic blood pressure≥95th percentile for age, gender and height on ≥3 occasions. Data from the National Health and Nutrition Examination Survey and from a Houston-based study were used for comparison.


RESULTS:
Fifty-one (41.5%) patients were hypertensive. This was significantly higher than the 3% prevalence in the national controls, p<0.001 and the 4.5% prevalence in the Houston controls, p<0.001. Maximum body mass index increased the risk for HTN [odds ratio, 1.018; 95% confidence interval (1.005, 1.031); and p=0.005].

CONCLUSION:
Children with SB have a significantly higher prevalence of HTN than children in the general population. Age-, gender-, and height-based norms are important for the early identification and treatment of HTN in children.

PMID: 21342248