Rutgers University: Steroid Use in Childhood Can Lead to Hypertension

A study has found that children who use steroids for the treatment of autoimmune or other diseases like asthma have a high risk of developing hypertension, diabetes mellitus, and venous thromboembolism (VTE).

Cortisol

Glucocorticosteroids, a class of corticosteroids, are a class of medication used in the treatment of autoimmune diseases, asthma, adrenal insufficiency, and many other medical conditions. Children have often been prescribed corticosteroids, or more commonly known as steroids, for the treatment of persistent asthma and sometimes, hay fever (rhinitis). However, steroids are never prescribed to children for long-term use since they can be accompanied by undesirable results.

The side effects of corticosteroids on adults are well understood, and so is their mechanism of action. Due to this, corticosteroids are prescribed with caution. This also applies to the prescription of steroids to children, however, in children, the long-term side effects of corticosteroid consumption are not clearly understood. In an attempt to understand the long-term consequences associated with steroid use in childhood, Dr. Horton from the department of Pediatrics at Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, and his team performed a retrospective cohort study.

Method of the new study

In the retrospective cohort, data of two groups of children were identified; one group consisting of those prescribed corticosteroids for the treatment of auto-immune diseases and the other group comprised of those prescribed corticosteroids for the treatment of non-immune comparator conditions. The data for the study was obtained from US Medicaid claims (2000-2010) and contained information on over 930,000 children between the ages of 1 to 18 years old.

Findings of the new study

The study was conducted with the objective of finding an association between medical conditions like hypertension, diabetes mellitus, and venous thromboembolism, more commonly known as blood clots, and childhood corticosteroid use.

In this study that was published in the American Journal of Epidemiology, Horton and his team found that children who suffered from an autoimmune disease like psoriasis, juvenile idiopathic arthritis, or inflammatory bowel disease were more likely to develop the long-term side effects of corticosteroids than those diagnosed with non-immune comparator conditions. They also found that both groups of children, those with and without autoimmune diseases had an increased risk of developing hypertension, and a low risk of developing VTE or blood clots.

They also found a dose-related association with children receiving higher doses of corticosteroids at a higher risk of developing hypertension than those receiving a lower dose. The results of the study showed a high relative risk between the use of high-dose oral steroids and the above-mentioned side effects but a low absolute risk overall.

Despite the findings of complications associated with steroid use in children, Horton claims that children who use steroids for a short period of time for diseases like asthma are at very low risk for developing the side effects mentioned above.