Elevated blood pressure in the paediatric population: the Nigerian experience
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261522Keywords:
Childhood hypertension, Antihypertensives, GuidelinesAbstract
Background: The prevalence of hypertension in children is increasing, hence the need for updated information on the causes, clinical assessment, and treatment of childhood hypertension among Pediatricians. This study assessed the experiences and challenges in the management of childhood hypertension among Pediatricians in Nigeria.
Methods: The study was a cross-sectional study conducted from responses from 73 Paediatric cardiologists and residents. An online self-administered structured questionnaire was used to collect information from participants. The results were analyzed using Statistical Package for the Social Sciences (SPSS) version 25.
Results: Sixty-nine (94.5%) participants practiced at the tertiary level of health care. Respondents came from the country's geopolitical zones, mostly the south West (39.7%). About a third (31.5%) of children have elevated blood pressure on average. The availability of age-appropriate blood pressure monitoring instruments increased with age (from 60.3% in infants to 94.5% in adolescents). The nephrologist manages childhood hypertension in most centers (38.4). Secondary hypertension was the more common cause reported by respondents (91.8%), and acute glomerulonephritis (22.3%) and renal parenchymal disease (15.6%) were the leading causes. Almost half 34 (46.6%) are aware of guidelines for the management of hypertension in children, but only 64.7% of these use any. The calcium channel blockers (72.9%) are the leading antihypertensives used by respondents, and hydralazine is used for hypertensive emergencies.
Conclusions: There are still challenges with the diagnosis and management of childhood hypertension in Nigeria. Providing age-appropriate BP measurement equipment and following management guidelines would enhance the care of childhood hypertension nationwide.
References
Riley M, Hernandez AK, Kuznia AL. High blood pressure in children and adolescents. Am Fam Physician. 2018;98(8):486-94.
Ibrahim OR, Afolabi JK, Adedoyin OT, Ojuawo AI. Prevalence and risk factors for hypertension among school children in Ilorin, North-central Nigeria. J Family Community Med. 2019;26(3):181-6.
Noubiap JJ, Essouma M, Bigna JJ, Jingi AM, Aminde LN, Nansseu JR. Prevalence of elevated blood pressure in children and adolescents in Africa: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e375-86.
Bell CS, Samuel JP, Samuels JA. Prevalence of hypertension in children. Hypertension. 2019;73(1):148-52.
Okpokowuruk FS, Akpan MU, Ikpeme EE. Prevalence of hypertension and prehypertension among children and adolescents in a semi-urban area of Uyo Metropolis, Nigeria. Pan Afr Med J. 2017;28:303.
Ejike CECC. Prevalence of hypertension in Nigerian children and adolescents: a systematic review and trend analysis of data from the past four decades. J Trop Pediatr. 2017;63(3):229-41.
Onagbiye S, Toriola A. Comparison of the prevalence of hypertension using Fourth Report and the AAP guidelines among Nigerian children and adolescents. Med Sci Sports Exerc. 2020;52(7):798.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904.
U.S. Preventive Services Task Force. Screening for high blood pressure in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(9):1.
Flynn JT, Pierce CB, Miller ER, Charleston J, Samuels JA, Kupferman J, et al. Reliability of resting blood pressure measurement and classification using an oscillometric device in children with chronic kidney disease. J Pediatr. 2012;160(3):434-40.
Chio SS, Urbina EM, LaPointe J, Tsai J, Berenson GS. Korotkoff sound versus oscillometric cuff sphygmomanometers: comparison between auscultatory and pulse blood pressure measurements. J Am Soc Hypertens. 2011;5(1):12-20.
Carretero OA, Oparil S. Essential hypertension. Circulation. 2000;101(3):329-35.
Uwaezuoke SN, Okoli CV, Ubesie AC, Ikefuna AN. Primary hypertension among a population of Nigerian secondary school adolescents: prevalence and correlation with anthropometric indices: a cross-sectional study. Niger J Clin Pract. 2016;19(5):649.
Bello JK, Mohanty N, Bauer V, Rittner SS, Rao G. Pediatric Hypertension: Provider Perspectives. Global Pediatric Health. 2017;4:2333794X17712637.
University of Nottingham. Does my research need ethical approval?. Nottingham: University of Nottingham. Available at: https://www.nottingham.ac.uk. Accessed on 24 January 2026.
Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41(12):1874.
Spagnolo A, Giussani M, Ambruzzi AM, Bianchetti M, Maringhini S, Matteucci MC, et al. Focus on prevention, diagnosis, and treatment of hypertension in children and adolescents. Ital J Pediatr. 2013;39:20.
Obrycki Ł, Skoczyński K, Sikorski M, Koziej J, Mitoraj K, Pilip J, et al. Current etiology of hypertension in European children – role of serum uric acid. medRxiv. 2024.
Kadiri S, Arogundade F, Arije A, Omotoso A, Onwubere B, Aderibigbe A, et al. Guidelines for the Management of Hypertension in Nigeria 2020. Trop J Nephrol. 2020;15(1):65-84.
Downloads
Published
How to Cite
Issue
Section
