Hospitalizations for pediatric hypertension double

Hospitalizations of children with hypertension doubled over a 10-year period. A recent study suggests why and reveals which children are at greatest risk.

Touting their research as the first nationally based study to examine pediatric hypertension hospitalizations, the investigators found that these hospitalizations increased from more than 12,000 in 1997 to more than 24,000 in 2006.

Using nationwide discharge data from the Healthcare Cost and Utilization Project Kids’ Inpatient Database, researchers calculated 71,282 pediatric hospitalizations with hypertension as the primary or secondary diagnosis during the 10-year period.

The price tag for these hospitalizations is a staggering $3.1 billion, representing a 50% increase during the decade. Length of stay contributed to the problem; children with hypertension stayed in the hospital twice as long as those without (8 days vs 4 days). The most significant increases in charges were for children with hypertension and end-stage renal disease (ESRD); 6% of hospital admissions had diagnosis codes for both hypertension and ESRD or renal transplant.

Most (68%) of the hospitalizations were in 10- to 18-year-olds. The researchers surmise that this probably relates to the rise in adolescent obesity. The American Heart Association says that about 1 in 3 children and adolescents is overweight or obese-almost triple the rate in 1963.

The researchers found that a little more than 9% of children with hypertension also had a code for obesity; of those with obesity, 91% were 10- to 18-year-olds. However, the researchers used a database that didn’t capture body mass data, they say, and coding for obesity can be unreliable, especially because it isn’t typically reimbursable.

Those children admitted for hypertension also tended to be boys (55%), black (53%), and treated in a teaching hospital.

When hypertension was the primary diagnosis, the most common secondary diagnoses were convulsive disorder not otherwise specified, headache, obesity, and systemic lupus erythematosus (SLE). The most common primary diagnoses to accompany hypertension were SLE, kidney transplant complications, pneumonia-organism not otherwise specified, and acute proliferative glomerulonephritis.

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