Health-related quality of life in paediatric arterial hypertension: a cross-sectional study

Background: The prevalence of paediatric hypertension is increasing worldwide, especially due to the childhood obesity epidemic, and is an important public-health concern. While the Health-Related Quality of Life (HRQoL) was already shown to be impaired in the adult hypertensive population, a scarcity of data still exists on HRQoL in paediatric hypertensive patients. Our purpose was thus to assess the HRQoL of children and adolescents with arterial hypertension, using self-and proxy-reports, and to determine the correlations between child and parent questionnaire scores. Methods: The Paediatric Quality of Life Inventory (TM) 4.0 Generic Core Scales were administered via post to children and adolescents, aged 5-18 years, with primary or secondary arterial hypertension and parents as proxy-reports. Patients were recruited from a paediatric nephrology unit in a tertiary hospital, using an out-patient clinic visit registry. Healthy school children and adolescents from a local primary school, aged 6 to 15 years, and their parents formed the control group. HRQoL group comparisons were calculated with independent samples t-test and child-parent correlations with the Pearson's r correlation coefficient. Results: In total we recruited 139 patient and 199 control group participants as self-and proxy-reports. Scores from self-as well as proxy-reports indicated a significantly lower overall HRQoL in the paediatric hypertensive population (95% CI for mean score difference: - 11.02, - 2.86 for self- and - 10.28, - 2.67 for proxy-reports; p =.001). In self- reports, lower physical (95% CI: - 13.95, - 4.89; p = <.001), emotional (95% CI: 12.96, - 2.38; p = .005), school (95% CI: - 11.30, - 0.42; p = .035), and psychosocial functioning scores were observed (95% CI: - 10.34, - 1.89; p =.005). Parent proxy-reports were lower in physical (95% CI: - 14.31, - 5.39; p = <.001), emotional (95% CI: - 12.39, - 2.60; p = .003) and psychosocial scores (95% CI: - 9.36, - 1.34; p = .009). Pearson's r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p <.001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p <.001). Conclusions: This cross-sectional study gives insight into the detrimental impact of hypertension on children's and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients' physical and psychosocial well-being throughout their development.