소아 고혈압의 평가와 관리 방법에 대한 한국 소아청소년 전문의 설문조사
A survey of Korean Pediatricians on how to evaluate and manage the hypertensive in children
- 주제(키워드) Hypertension , Children , Adolescents , Management , Survey
- 발행기관 고려대학교 대학원
- 지도교수 유기환
- 발행년도 2008
- 제출일 2008-07-02
- 학위수여년월 2008. 8
- 학위명 석사
- 학과 일반대학원 의학과
- 세부전공 소아과학
- 원문페이지 33 p
- 본문언어 한국어
- 제출원본 000045501059
초록/요약
Purpose : Hypertension(HTN) is no longer viewed as an adult disease, and the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment for childhood HTN in Korea, we investigated how hypertensive children are currently assessed and managed by pediatricians. Methods : We sent a questionnaire on how to manage hypertensive children to 159 pediatricians who registered at the Korean Society of Pediatric Nephrology and the Korean Pediatric Heart Association. Results : A total of 75 replies were received (response rate 47%). 46.6% of the respondents were pediatric cardiologists(CA) and 37.3% were pediatric nephrologists(NE). NE checked routine Blood Pressure(BP) more than CA (CA 5.7% NE 25%, P=0.03) but most of respondents did not check BP routinely in outpatient clinics (86% of respondents). A mercury sphygmomanometer was the most commonly used for BP measurements. CA used Ambulatory Blood Pressure Monitoring more frequently than NE. BP treatment goals were usually set at the 95th percentile for age, gender, and height by 61% of respondents. And most of respondents did not set the different goal according to the underlying disease present. Angiotensin Converting Enzyme inhibitor was most commonly used as a first choice drug (mean 59%). According to the underlying disease present, NE prescribe more various drugs than CA. For BP monitoring, self-monitoring was found to be the most frequent method. Conclusion : In Korea, BP measurement is not a routine examination yet. In infants and young children, primary hypertension is uncommon but adolescents may have more chance to develop primary and secondary hypertension. It may track into adult hypertension which prone to develop secondary diseases in adulthood. So the proper management of hypertension in children and adolescents is very important. In our study, pediatricians use ACE inhibitor more frequently than any other antihypertensive drugs as a first choice drug. The second choice drugs are diuretics for CA and calcium channel blocker for NE. But for the appropriate management and prevention of secondary diseases, a standard guideline and educations would be needed for pediatricians through long-term study.
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