ACUTE HYPERTENSION AS A CLINICAL MANIFESTATION IN ADOLESCENTS WITH SUBSTANCE OF ABUSE OVERDOSE: A SIX-YEAR MULTICENTER ANALYTICAL STUDY

Objective: Hypertension and its development during adolescence is increasingly recognized as a significant risk factor for cardiovascular diseases later in life. The circumstances under which it can occur are varied, drug overdose being one of them. The mechanisms of hypertension in acute overdose are multiple: stimulation of the sympathoadrenal system, stimulation of the renin-angiotensin-aldosterone system, damage to the endothelium (vasoconstriction) and electrolyte imbalances. The objective of this study is to analyse the characteristics of hypertension in substance of abuse overdose. Design and method: We conducted a descriptive study over six years (January 2017 - December 2022) involving patients under 18 years of age admitted for substance of abuse overdose in three paediatric poison centres in Romania. Statistical analysis was performed using Microsoft Excel and Socscistatistics Software. Results: The study cohort consisted of 462 patients with ages between 8 and 18 years. The average length of hospital stay was 1.9 days. When analysing the cohort, we found that 218 patients (47.1%) where chronic consumers of substances of abuse, while in 102 cases (22%) 2 or more substances were involved. Chronic use of substances is associated with an increased risk of developing high blood pressure (p=0.04). Simultaneous use of multiple substances is not associated with hypertension (p=0.88). Out of a total of 462 patients, in 154(33.3%) cases a high level of blood pressure was detected, of which systolic high blood pressure was present in 19.6% of cases (91) and diastolic high blood pressure in 13.6% (63). Analysing the symptoms, we noted that chest pain in these patients with substance of abuse overdose is associated with changes in cardiac enzyme values(p=0.01) and tachycardia is a risk factor in development of hypertension(p=0.0001). Conclusions: The study highlights the significant link between drug use and the development of hypertension in adolescents, particularly among chronic users and those using multiple substances. Tachycardia in adolescents with an overdose of substance of abuse is correlated with the presence of high blood pressure.