SEX DIFFERENCES IN PEDIATRIC HYPERTENSION

Pediatric hypertension, linked to long-term cardiovascular risks, shows increasing prevalence and varying patterns between boys and girls. This study explores sex-based differences in hypertension among 251 children aged 6-18 from Kentucky Children’s Hospital. Using 24-hour ambulatory blood pressure monitoring (ABPM) and assessing plasma renin, aldosterone, and cortisol, we examined blood pressure severity by sex. Girls showed a higher incidence of severe hypertension and elevated cortisol levels, whereas boys had higher mean systolic blood pressure. Aldosterone was associated with night systolic blood pressure in girls, while night diastolic blood pressure was linked to aldosterone in both sexes and renin in girls. Tests of between-subject effects revealed that cortisol, BMI, and age influenced blood pressure differently across sexes. These results suggest unique physiological mechanisms in boys and girls, emphasizing the need for sex-specific diagnostic criteria and interventions. Tailored approaches to pediatric hypertension may improve early detection and mitigate adult cardiovascular risks.