Prevalence of Hypertension in Pediatric Tibia Vara and Slipped Capital Femoral Epiphysis
| Autor: | Janet L. Walker, Kenneth P. Powell, Tracy Warhoover, Spencer E. Romine, Heather A. Cole, Matthew D. Taussig, Jeffrey E. Martus, Steven A. Lovejoy, Vishwas Talwalkar, Jonathan G. Schoenecker, Henry J. Iwinski, Samuel K. Nwosu, Gregory A. Mencio, Todd A. Milbrandt, Tray Hunley |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Bone disease Adolescent Blood Pressure Slipped Capital Femoral Epiphyses Childhood obesity Prehypertension 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics medicine Prevalence Humans Osteochondrosis Orthopedics and Sports Medicine Tibia Risk factor Child 030222 orthopedics Bone Diseases Developmental business.industry General Medicine medicine.disease United States Blood pressure Child Preschool Pediatrics Perinatology and Child Health Hypertension Female Slipped capital femoral epiphysis business Body mass index |
| Zdroj: | Journal of pediatric orthopedics. 36(8) |
| ISSN: | 1539-2570 |
| Popis: | Background Slipped capital femoral epiphysis (SCFE) and tibia vara (Blount disease) are associated with childhood obesity. However, the majority of obese children do not develop SCFE or tibia vara. Therefore, it is hypothesized that other obesity-related biological changes to the physis, in addition to increased biomechanical stress, potentiate the occurrence of SCFE and tibia vara. Considering that hypertension can impose pathologic changes in the physis similar to those observed in these obesity-related diseases we set out to determine the prevalence of hypertension in patients with SCFE and tibia vara. Methods Blood pressure measurements were obtained in 44 patients with tibia vara and 127 patients with SCFE. Body mass index and blood pressure were adjusted for age, sex, and height percentiles utilizing normative distribution data from the CDC. These cohorts were compared with age-matched and sex-matched cohorts derived from an obesity clinic who did not have either bone disease. A multivariable proportional odds model was used to determine association. Results The prevalence of prehypertension/hypertension was significantly higher in the tibia vara (64%) and SCFE cohort (64%) compared with respective controls (43%). Patients diagnosed with either SCFE or tibia vara had 2.5-fold higher odds of having high blood pressure compared with age-matched and sex-matched obese patients without bone disease. Sex, age, and race did not have a significant effect on a patient's blood pressure. Conclusions This is the first study to establish that the obesity-related bone diseases, SCFE and tibia vara, are significantly associated with high blood pressure. These data have immediate clinical impact as they demonstrate that children with obesity-related developmental bone disease have increased prevalence of undiagnosed and untreated hypertension. Furthermore, this prevalence study supports the hypothesis that hypertension in conjunction with increased biomechanical forces together potentiate the occurrence of SCFE and tibia vara. If proven true, it is plausible that hypertension may represent a modifiable risk factor for obesity-related bone disease. Level of evidence Level III-case-control study. |
| Databáze: | OpenAIRE |
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