The prevalence of hypertension in children with spina bifida

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.