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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 3  |  Page : 690-692

Features of anxiety and arterial pressure level in children with chronic gastroduodenal pathology


1 Department of Pediatrics, Neonatology and Perinatal Medicine, Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi, Ukraine
2 Department of Practical Psychology, Faculty of Pedagogic, Psychology and Social Work, Chernivtsi National University named after Y. Fedkovich, Chernivtsi, Ukraine

Date of Submission24-Sep-2019
Date of Decision22-Dec-2020
Date of Acceptance26-Jan-2021
Date of Web Publication2-Nov-2022

Correspondence Address:
Dr. Natalia I Kovtyuk
Golovna Str. 190A/18, Chernivtsy 58018
Ukraine
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_142_19

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  Abstract 


Context: The children of the school-age are most prone to the development of hypertension, which is determined by the characteristic disorders of the autonomic function for this period of childhood, which is accompanied by an increased level of anxiety. Aims: The aim of this study was to assess the level of anxiety in the background of fluctuations of blood pressure (BP) in schoolchildren with chronic gastroduodenal pathology. Settings and Design: This was a cross-sectional study done in city children's clinical hospital conducted for 8 months. Subjects and Methods: One hundred and twenty children with chronic gastroduodenal pathology were examined. To assess the level of arterial hypertension by tonometry. Spielberger-Hanin scale was used to assess the level of personal and situational anxiety. Statistical Analysis Used: Statistical analysis was performed using descriptive and inferential statistics and software used in the analysis was Statistica 12 (Statsoft, USA) and P < 0.05 was considered as the level of statistical significance. Results: In assessing the level of BP in children by percentile tables, it was found that in the second group there is a greater tendency to hypertension than in the first group, and in the children of second group, there were higher rates of both systolic and diastolic BP. In addition, children of the second group experienced an increase in both the personal and situational levels of anxiety. Conclusions: Children with chronic hyperplastic and erosive gastroduodenitis more often observed an increase in BP, also they experience significantly higher levels of both personal and situational anxiety.

Keywords: Anxiety, arterial pressure, children, gastroduodenal pathology


How to cite this article:
Nechytailo YN, Nechytailo DY, Nechytailo TA, Kovtyuk NI, Mikhieieva TN, Poniuk VV. Features of anxiety and arterial pressure level in children with chronic gastroduodenal pathology. J Datta Meghe Inst Med Sci Univ 2022;17:690-2

How to cite this URL:
Nechytailo YN, Nechytailo DY, Nechytailo TA, Kovtyuk NI, Mikhieieva TN, Poniuk VV. Features of anxiety and arterial pressure level in children with chronic gastroduodenal pathology. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Feb 1];17:690-2. Available from: http://www.journaldmims.com/text.asp?2022/17/3/690/360179




  Introduction Top


As well known, the prevalence of arterial hypertension (AH) among children is much lower than in the adult population.[1],[2] However, according to some authors, over the past 25 years, Ukraine has experienced a negative trend: the prevalence of cardiovascular diseases, including hypertension, has tripled among children.[3],[4] According to the cardio rheumatic service for 2017, the incidence of children under the age of 17 years with diseases of the circulatory system in Ukraine is 10.31/1000; prevalence is - 35.34.[1]

The children of the school-age are most prone to the development of AH, which is determined by the characteristic disorders of this autonomic function for this period of childhood.[4],[5] Primary AH in children occurs much less frequently than in adults; its prevalence increases somewhat with age.[1] In children of the 1st year of life, as well as preschool age, AH develops extremely rarely and in most cases, has a secondary symptomatic nature.[4]

According to modern ideas, pronounced fluctuations of blood pressure (BP) reflect the disorder of neuroautonomic regulation of vascular tone, and with its progression, develop structural changes in blood vessels, especially in cellular membranes of the endothelium.[4],[6] Different mechanisms amplify each other, which leads to an overload of compressor systems and the development of hypertensio.[5],[6]

Timely detection of pathological tendencies in the development of the disease in adolescents and adequate diagnosis and correction of violations of BP levels in schoolchildren can significantly affect the health of the children population.[1],[2],[4],[5]

In the structure of the morbidity of children of the digestive system, the defeat of the gastroduodenal region occupies 75%.[7] The pathogenesis of chronic gastroduodenal diseases is complex and multifaceted.[7],[8]

Thus, it is expedient to examine the functional state of the cardiovascular system and assess the level of anxiety in children with chronic gastroduodenal pathology.

The objective of the study was to assess the level of anxiety in the background of fluctuations of BP in children of school age with chronic gastroduodenal pathology.


  Subjects and Methods Top


We surveyed 120 children who were inpatient treatment in the gastroenterology department of the city children's clinical hospital from the countryside and the city of Chernivtsi. The ratio of girls and boys was 1:1. The average age of children was 13.4 ± 0.12 years.

All children were divided into two groups: the first group (60 persons) included children with chronic superficial gastritis and gastroduodenitis; the second group (60 persons) consisted of children with chronic hyperplastic and erosive gastroduodenitis. Verification of diagnoses was carried out in accordance with the order of the Ministry of Health of Ukraine No. 59 “On the introduction of protocols for the treatment of children in the field of pediatric gastroenterology.”

We used clinical, anthropometric, laboratory, instrumental, and statistical methods. To assess individual parameters of the functional state of the cardiovascular system, the level of BP was measured. Tonometry was performed three times, with an interval of 3 min, on the shoulder artery of the left arm using an automatic tonometer.

As for the methodology for measuring BP in children, there are certain peculiarities that need to be taken into account to obtain an objective result. This applies to the measurement process itself and is associated with a large variation of the shoulder obstruction in school-age children.[4] Therefore, it is necessary to have a set of appropriate cuffs, which can be easily replaced if necessary. An important factor is the relative dependence of BP indicators on age, sex, and child's height. Unlike adults, in children, the standards should be determined by the corresponding percentile nomograms.

The results were evaluated by percentile nomograms according to age, sex, and height.

Spielberger-Hanin Scale was used to assess the level of personal and situational anxiety.

The mathematical processing of the data was performed using the Microsoft Office Excel and Statistica 12.


  Ethical clearance Top


The Institutional Ethics Committee of Neonatology and Perinatal Medicine, Higher State Educational Establishment of Ukraine has approved the Research work proposed to be carried out at Neonatology and Perinatal Medicine, Higher State Educational Establishment of Ukraine, Date : 8th Feb 2017 with Reference no NPM/EIC/2017-18/238.


  Results Top


The nosological structure of diseases among the children of the first group was as follows: 23 (38.3%) children were diagnosed with chronic surface gastritis, and 37 (61.7%) - chronic surface gastroduodenitis. In the second group: 39 (65%) children were diagnosed with chronic hyperplastic gastroduodenitis, and 21 (35%) children were chronic erosive gastroduodenitis.

The following results were obtained during the tonometry: in children of the first group, average systolic blood pressure (SBP) was 114.0 ± 0.6 mm Hg; average diastolic blood pressure (DBP) - 61.3 ± 0.4 mm Hg. In children of the second group, the average SBP was 119.4 ± 0.9 mm Hg (P < 0.05); the average DBP was 67.0 ± 1.1 mm Hg (P < 0.05).

It is necessary to draw attention to the fact that in most children of the first group, the level of SBP was within 105–117 mm Hg. In the majority of children of the second group, the SBP was within 111–124 mm Hg.

In more children of the second group DBP was within 50–70 mm Hg, in the majority of children of the first group DBP was 56–77 mm Hg.

Thus, in children of the second group, unlike children of the first group, there were more likely causes of the increase of BP levels of both SBP and DBP.


  Discussion Top


The assessment of the level of BP in children was carried out on the percentile tables. The level of SBP and DBP was within the corridor of 90%–95% in 14 patients (12.0%) from both groups, which was assessed as arterial prehypertension; in 7 children (5.8%) - exceeded 95% and was estimated as arterial hypertension. After analyzing these indicators in children divided by groups, we obtained the following results [Figure 1].
Figure 1: The level of blood pressure in children of the first and second groups, (P < 0.05). SBP level: systolic blood pressure level, DBP level: diastolic blood pressure level

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In this figure, it is clear that in children of the second group there is a greater tendency to hypertension than in children of the first group.

One of the leading mechanisms of the development of gastroduodenal pathology is disorders in the autonomic sphere, which cause certain changes in other systems of the body, in particular cardiovascular.

The average level of situational anxiety in children of the second group was 35.4 ± 1.4 points, which is a moderate level of anxiety. The average level of anxiety in children of the 1st group was low - 25.6 ± 1.1 points (P < 0.001). A similar pattern was observed when assessing the level of personal anxiety. The average level of personal anxiety in children from the second group was 42.6 ± 1.9 points, which is actually bordered with a high level of anxiety. In addition, 4 (25%) children personal anxiety level was above 40 points, which mean a high index. In the first group, the average level of personal anxiety was low and had 26.7 ± 1.2 points (P < 0.001).

Generally, hypertension in children is the result of autonomic dysfunction, which in turn is closely related to the psychological state of the child and the level of anxiety [Figure 2].
Figure 2: The anxiety level in children of the first and second groups, (P < 0.001)

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  Conclusions Top


Thus, we can conclude (1) Children of the second group more often observed a possible increase in SBP and diastolic blood pressure; (2) In the second group, there were found more children with arterial hypertension than in the first group. This may be due to the presence of more pronounced organic lesions of the mucous membrane of the stomach and duodenum; (3) School-age children with arterial hypertension combined with chronic erosive injury in the stomach and duodenum noted significantly higher levels of both personal and situational anxiety, which have a negative impact on the prognosis of the disease course. It can be caused by autonomic dysregulation. (4) In addition, for more effective treatment of hypertension combined with chronic erosive injury in the stomach and duodenum in school-age children, special attention should be given to methods of anxiety level reducing.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Majdannyk VH, Xajtovych MV. Pervynna arterialna hipertenziya u pidlitkiv: Problemni pytannya ta perspektyvy. Pediatriya Akusherstvo Hinekolohiya2012;4:90-1.  Back to cited text no. 1
    
2.
Beketova NV. Xronichnyj hastroduodenit u ditej i pidlitkiv: epidemiolohiya, etiolohiya, patohenez, diahnostyka. Sovremennaya Pedyatryya2012;6:20-4.  Back to cited text no. 2
    
3.
Berezhnyj VV, Marushko TV, Romankevych IV. Stan nadannya kardiorevmatolohichnoyi dopomohy dityam Ukrayiny. Sovremennaya Pedyatryya2014;33:14-7.  Back to cited text no. 3
    
4.
Chiolero A. The quest for blood pressure reference values in children. J Hypert 2014;32:477-9.  Back to cited text no. 4
    
5.
Ivanko OH. Dosvid orhanizaciyi fizychnoyi reabilitaciyi pidlitkiv 16-17 rokiv z arterialnoyu hipertenziyeyu v umovax navchal”noho zakladu. Sovremennaya Pedyatryya 2014;3:89-93.  Back to cited text no. 5
    
6.
Bobrova VI, Koshova AO, Vorobiyenko YI. Vikovi osoblyvosti klinichnoho perebihu xronichnoyi hastroduodenal noyi patolohiyi v ditej. Perynatolohyya Pedyatryya2013;2:73-7.  Back to cited text no. 6
    
7.
Ahapytov LY, Leonteva YV. Arteryalnaya hypertenzyya. Rukovodstvo po farmakoterapyy v pedyatryy y detskoj xyrurhyy. 2014;5:177-201.  Back to cited text no. 7
    
8.
Majdannyk VH. Kliniko-patohenetychna xarakterystyka vehetatyvnyx dysfunkcij ta yix likuvannya u ditej: Navch. posib. Sumy: Sums”kyj Derzhavnyj Universytet; 2013. p. 172s.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2]



 

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Abstract
Introduction
Subjects and Methods
Results
Discussion
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Ethical clearance
References
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