The clinical features and related factors of anxiety in children with essential hypertension

Objective To investigate the clinical characteristics and related factors of anxiety in children with essential hypertension, providing evidence for early identification and clinical intervention.

Methods The clinical data of 104 children with essential hypertension who were hospitalized in the Department of Pediatric Cardiology, Capital Center for Children's Health, Capital Medical University from July 2024 to December 2024 were retrospectively collected, and the anxiety symptoms in the children were assessed using the Screen for Child Anxiety Related Emotional Disorders (SCARED). Based on the presence or absence of anxiety symptoms, the patients were divided into the hypertension with anxiety group and the hypertension group. The clinical data of the two groups were compared. The patients were divided into the stage 1 hypertension group and the stage 2 hypertension group based on the hypertension classification criteria, and the anxiety scale scores were compared between the two groups. According to the presence or absence of target organ damage (TOD), the patients were categorized into the non-TOD and the TOD group, with anxiety scale scores subsequently compared between these two groups. The Spearman correlation coefficient was used to analyze the correlation between the total score of the SCARED and blood pressure level in children with essential hypertension. Multivariate logistic regression was used to explore the independent related factors of anxiety in children with essential hypertension.

Results A total of 104 children with essential hypertension were included in this study, including 40 cases in the hypertension with anxiety group and 64 cases in the hypertension group. The proportion of hypertension stage 2 (62.50%25/40 vs 40.62% 26/64, χ² = 4.71, P = 0.03), the total score of the SCARED (30.00 25.00, 35.50 points vs 14.00 9.00, 19.00 points, Z = –8.56, P＜0.01), 24 h systolic blood pressure (SBP) (134.00 126.00, 143.00 mmHg vs 125.00 121.75, 129.25 mmHg, Z = –4.98, P＜0.01), 24 h diastolic blood pressure (DBP) (77.00 74.00, 83.50 mmHg vs 74.00 70.00, 77.00 mmHg, Z = –3.07, P＜0.01), daytime SBP (137.00 129.00, 145.00 mmHg vs 129.50 126.00, 133.00 mmHg, Z = –4.67, P＜0.01), daytime DBP (80.00 75.75, 86.50 mmHg vs 77.00 73.00, 81.00 mmHg, Z = –2.73, P＜0.01) in the hypertension with anxiety group were significantly higher than that of the hypertension group. The total score of the SCARED in the stage 2 hypertension group was higher than that of the stage 1 hypertension group (22.00 16.00, 29.00 points vs 16.00 11.00, 24.00 points, Z = –2.43, P = 0.02), and the total score of the SCARED in the TOD group was higher than that of the non-TOD group (20.00 14.00, 26.75 points vs 15.00 9.00, 25.00 points, Z = –2.03, P = 0.04). Spearman correlation analysis showed that 24hSBP, 24hDBP, daytime SBP and daytime DBP were correlated with the total score of the SCARED (r = 0.45, 0.27, 0.45, 0.24, all P＜0.05). Multivariate logistic regression analysis showed that elevated 24hSBP was an independent related factor for anxiety in children with essential hypertension (OR = 1.28, 95%CI 1.13 to 1.44, P＜0.01).

Conclusions Elevated 24hSBP is an independent related factor for anxiety in children with essential hypertension. It helps in the early identification of anxiety in children with essential hypertension, providing a basis for the individualized treatment and comprehensive management of hypertension.