SOVREMENNAYA PEDIATRIYA.2016.7(79):88-93; doi 10.15574/SP.2016.79.88 

Adaptation phase in children with primary hypertension 

Hyschak T. V., Marushko Iu. V.

Bogomolets National Medical University, Kiev, Ukraine 

Objective: to characterize the clinical-pathogenetic adaptation phase in children with primary arterial hypertension (PH) and to develop an algorithm of them diagnosis.

Material and methods. The study involved 194 children with PH at the age of 9–12 years. All children held general-clinical examination; daily blood pressure monitoring (ABPM); survey on self-test functional state (FAM) and the subjective assessment of the quality of nighttime sleep (SLEEP); determining the level of «free cortisol», 6-sulfatoxymelatonin (6-COMT) in urine, N-terminal fragment of brain natriuretic peptide (NT-proBNP), thromboxane (TXB2) and prostacyclin (6-PGF1α) in serum, bicycle stress test and ultrasound echocardiography. In order to systematize the data held agglomerative hierarchical cluster analysis of one-dimensional asymmetrically distributed data.

Results and its discussion. The study developed an algorithm for the diagnosis of clinical-pathogenetic adaptation phase in children with PH. According to the algorithm to determine the clinical-pathogenetic phase adaptation of children with PAH is necessary to conduct ABPM. Depending on hypertension forms, indicators of average daily systolic blood pressure (SBP), the results of tests FAM and the SLEEP, magnesium and NT-proBNP levels in the blood serum, level of exercise tolerance and the presence or absence of left ventricular hypertrophy determined by clinical-pathogenetic adaptation phase and assigned appropriate treatment.

Conclusions. Primary hypertension in children is characterized by a change in the phase of adaptation as its progression from initial desadaptation through a phase of adaptation's compensation to the secondary desadaptation. Clinical-pathogenetic adaptation phase should be taken into account when assigning the treatment of children with PH, spending as the selection of therapy, and checking the effectiveness of therapeutic interventions.

Key words: primary hypertension, children, adaptation.

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