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Young Adults with Spina Bifida May Have Higher Occurrence of Prehypertension and Hypertension

Stepanczuk, Beth C. MD; Dicianno, Brad E. MD; Webb, Thomas S. MD, FAAP

American Journal of Physical Medicine & Rehabilitation: March 2014 - Volume 93 - Issue 3 - p 200–206
doi: 10.1097/PHM.0b013e3182a92b03
Original Research Articles

Objective: The aims of this study were to determine the occurrence of prehypertension and high blood pressure in adults with spina bifida (SB) and to examine relationships among blood pressure, cardiovascular disease risk factors, and SB-specific factors.

Design: This is a cross-sectional, retrospective analysis of adults with SB. SB-specific factors and cardiovascular disease risk factors were compared among subjects with high blood pressure, subjects with blood pressure in the prehypertensive range, and normotensive subjects using the χ2, Kruskal-Wallis, or Fisher’s exact tests.

Results: Of 225 subjects, the occurrence of prehypertension and high blood pressure was 27% (n = 22) and 27% (n = 22) for ages 18–29 yrs, 35% (n = 26) and 41% (n = 30) for ages 30–39 yrs, 18% (n = 8) and 66% (n = 29) for ages 40–49 yrs, and 21% (n = 5) and 67% (n = 16) for 50 yrs or older, respectively. Of the subjects with high blood pressure, 56% were men, 14% had obstructive sleep apnea, 14% had diabetes, 19% had renal dysfunction, 38% used tobacco, 16% had hydronephrosis, and 71% had a shunt. The groups differed significantly with respect to diabetes (P = 0.004), bladder procedures (P = 0.001), and renal dysfunction (P < 0.001), with higher proportions of subjects with high blood pressure having these comorbidities.

Conclusions: Fewer than half of the subjects were considered normotensive. A greater proportion of young adults with SB appear to have high blood pressure compared with the general United States population. Because elevated blood pressure is an independent, modifiable risk factor of cardiovascular disease, these findings support early screening and intervention for elevated blood pressure in individuals with SB.

From the Department of Physical Medicine and Rehabilitation (BCS, BED) and Adult Outpatient Spina Bifida Clinic (BED), University of Pittsburgh Medical Center, Pennsylvania; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pennsylvania (BED); Department of Rehabilitation Science and Technology, University of Pittsburgh, Pennsylvania (BED); and Huntersville Pediatrics and Internal Medicine, Huntersville, North Carolina (TSW).

All correspondence and requests for reprints should be addressed to: Brad E. Dicianno, MD, Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, 3471 5th Ave, Suite 202, Pittsburgh, PA 15213.

Supported by funds from the Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins