Multiple sclerosis and related disorders · 2025
Prevalence of hypertension in pediatric-onset multiple sclerosis and associations with disease course: A case-control study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Dinov Darina, Richie Alexia, Kent Brenna, Oh Unsong, Goldman Myla D, Brenton J Nicholas
Аннотация
BACKGROUND: Adults with multiple sclerosis (MS) have a higher prevalence of hypertension (HTN) which associates with greater disability and worsened clinical outcomes; however, the prevalence of this in pediatric-onset MS (POMS) is unknown. The aim of this study is to identify the prevalence of HTN in POMS and evaluate the association between HTN and POMS disease activity.
METHODS: This multicenter retrospective study evaluated blood pressure (BP) recordings in individuals with POMS (iwPOMS) compared to matched controls. Four time points were assessed: baseline visit and follow-up at 6, 12, and 24 months. HTN was defined as ≥3 BP recordings either ≥130/80 or >95 % for age, sex, and weight per American Academy of Pediatrics guidelines. Neutrophil-to-lymphocyte ratio and new, T2-hyperintense lesion count on MRI were recorded as a metric of disease activity or progression in iwPOMS.
RESULTS: Ninety-six iwPOMS and 96 matched controls were included. Compared to controls, iwPOMS had a higher prevalence of HTN (POMS with HTN 22 % vs. controls with HTN 6 %; p = 0.0018). Additionally, iwPOMS exhibited elevated systolic BP recordings compared to controls at baseline (35 % vs. 9 %; p = 0.0002) and longitudinally at 12-months (36 % vs. 13 %; p = 0.007) and 24-months (38 % vs. 14 %; p = 0.005). Presence of new T2-hyperintense lesions was higher at 24 months in iwPOMS with HTN (73 % vs 40 %; p = 0.04), despite similar patterns of DMT use. Neutrophil-to-lymphocyte ratio was not different between groups.
CONCLUSION: Compared to matched controls, iwPOMS have a higher prevalence of HTN. The co-morbid presence of HTN in youth with MS may heighten risk of inflammatory lesion development.
METHODS: This multicenter retrospective study evaluated blood pressure (BP) recordings in individuals with POMS (iwPOMS) compared to matched controls. Four time points were assessed: baseline visit and follow-up at 6, 12, and 24 months. HTN was defined as ≥3 BP recordings either ≥130/80 or >95 % for age, sex, and weight per American Academy of Pediatrics guidelines. Neutrophil-to-lymphocyte ratio and new, T2-hyperintense lesion count on MRI were recorded as a metric of disease activity or progression in iwPOMS.
RESULTS: Ninety-six iwPOMS and 96 matched controls were included. Compared to controls, iwPOMS had a higher prevalence of HTN (POMS with HTN 22 % vs. controls with HTN 6 %; p = 0.0018). Additionally, iwPOMS exhibited elevated systolic BP recordings compared to controls at baseline (35 % vs. 9 %; p = 0.0002) and longitudinally at 12-months (36 % vs. 13 %; p = 0.007) and 24-months (38 % vs. 14 %; p = 0.005). Presence of new T2-hyperintense lesions was higher at 24 months in iwPOMS with HTN (73 % vs 40 %; p = 0.04), despite similar patterns of DMT use. Neutrophil-to-lymphocyte ratio was not different between groups.
CONCLUSION: Compared to matched controls, iwPOMS have a higher prevalence of HTN. The co-morbid presence of HTN in youth with MS may heighten risk of inflammatory lesion development.