A5951 Hypertension in pediatric Takayasu arteritis

Abstract

Objectives: Pediatric Takayasu arteritis (TA) was limited reported with hypertension as the major clinical presentation. The study aims to investigate the presentation and management of hypertension in pediatric TA Methods: We retrospectively analyzed 103 pediatric TA patients hospitalized in Fuwai Hospital from 2002/01 to 2018/01. TA was diagnosed according to the diagnostic criteria recommended by ACR (1990) and the EULAR/ PRINTO/ PRES (2010). Childhood Hypertension was defined according to age-, gender- and height-specific 95th percentile based on the 2017 AAP guideline. Results: Hypertension was diagnosed in 69.9%. The female to male ratio was 2.4 to 1. The mean age of hypertension onset was 14.2 ± 3.0 years. Renal artery stenosis was the most common cause (57, 79.2%), followed by stenosis in abdominal aorta (31.9%), thoracic aorta (9.7%) and severe aortic regurgitation (2.8%). The mean clinic BP (66without bilateral subclavian artery stenosis, 91.7%) was 159.2 ± 25.1 mmHg /93.7 ± 20.0mmHg, while the mean central BP (26, 36.1%) was 166.4 ± 25.6mmHg/97.0 ± 20.2mmHg. 62 (86.1%) were combined systolic and diastolic high BP, while 10 were isolated systematic high BP. Anti-hypertensive drugs (mean categories:2.2 ± 0.9)were prescribed in 83.3% patients. Revascularization therapy was performed in 49 (68.1%) patients. At a mean follow-up of 38.6 ± 37.8 months, 58.7% patients remain with hypertension with 1.8 ± 1.1 kinds of antihypertensive drugs. Re-interventional management was operated in 19.4% patients Conclusion: The prevalence of hypertension in pediatric TA is remarkable with a relatively high male proportion. Renal artery stenosis, followed by stenosis in abdominal or thoracic descending aorta is the major pathology of hypertension. Antihypertensive and interventional therapy are significant in pediatric TA with hypertension.