ORIGINAL ARTICLE Journal of the College of Physicians and Surgeons Pakistan 2020, Vol. 30(11): 1175-1179 1175 Pulmonary Hypertension in Apparently Healthy Children in Southern Nigeria Chika O. Duru 1 , Patience A. Udo 2 , Moriam O. Lamina 3 and Josephat M. Chinawa 4 1 Department of Paediatrics and Child Health, College of Health Sciences, Niger Delta University, Amassoma, Bayelsa State, Nigeria 2 Department of Paediatrics, University of Uyo, Uyo Akwa Ibom State, Nigeria 3 Department of Paediatrics, University of Nigeria, Enugu, Enugu State, Nigeria 4 Department of Paediatrics, Lagos State University, Ikeja, Lagos State, Nigeria ABSTRACT Objective: To determine the severity and prevalence of pulmonary hypertension and its relationship with age and body mass index (BMI) in healthy children. Study Design: Observational study. Place and Duration of Study: University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Lagos State University Teaching Hospital, Niger Delta University Teaching Hospital, Bayelsa and Blessed Children Hospital Enugu from January 2010 to December 2019. Methodology: Four hundred and seventy (470) apparently healthy children aged 1 to 17 years underwent Doppler echocardiographic studies. Their tricuspid regurgitation velocity (TRV) was measured with continuous wave Doppler. Pulmonary artery systolic pressure (PASP) was estimated using the Bernoulli equation. Elevated PASP were determined at PASP ≥35/mmHg. Values were compared against age and BMI. Results: The mean age was 7.9 ± 3.3 years. Four hundred and fifty-nine subjects (97.7%) had normal PASP while 11 (2.3%) had elevated PASP. Those with elevated PASP had a significantly higher mean TRV of 2.7 ± 0.22 cm/s (95% CI; 2.55-2.85) vs TRV of 1.56 ± 0.43cm/s (95% CI; 1.52-1.60) and higher mean PASP of 39.27±4.89 mmHg (95% CI; 35.99-42.56) vs 20.45 ± 5.34 mHg (95% CI; 19.96-20.94) (p=0.001). Though majority of the children had appropriate weight for ages, those with elevated PASP had a significantly greater weight than those with normal PASP (p<0.001). There was a weak positive correlation of PASP with age (r=0.16) and BMI in normal weight (r=0.08). Obese children had a negative correlation value(r=-0.13). A weak negative correlation of PASP with BMI was seen in underweight (r=-0.17 and overweight (r=-0.73) children (p>0.05). Conclusion: The mean pulmonary artery systolic pressure in the studied apparently healthy Nigerian children was 20.45± 5.34/ mmHg. The frequency of elevated PASP was 2.3%, commoner in children with higher BMI. Age and body mass index are not optimal predictors of PASP. Key Words: Pulmonary artery systolic pressure, Children, Pulmonary hypertension, Echocardiography. How to cite this article: Duru CO, Udo PA, Lamina MO, Chinawa JM. Pulmonary Hypertension in Apparently Healthy Children in Southern Nigeria. J Coll Physicians Surg Pak 2020; 30(11):1175-1179. INTRODUCTION Pulmonary artery systolic pressure (PASP) represents the pres- sure exerted within the pulmonary vessels and provides a direct estimation of the right heart pressure. 1 The normal PASP at rest has been generally reported to be much lower than systolic blood pressure due to the large cross- sectional area of the pulmonary vasculature which leads to low resistance. 2 Pulmonary artery systolicpressuremeasurementisthekeytomakingadiagnosisof pulmonary hypertension which is the fourth most prevalent cardio- vascular disease worldwide. 1 Correspondence to: Dr. Josephat M. Chinawa, Department of Paediatrics, University of Nigeria, Enugu Campus, Nigeria E-mail: josephat.chinawa@unn.edu.ng ..................................................... Received: August 13, 2020; Revised: October 06, 2020; Accepted: November 02, 2020 DOI: https://doi.org/10.29271/jcpsp.2020.11.1175 Echocardiographyhasbeenrecognizedasareliablemethodfor non-invasive assessment of pulmonary artery pressures becauseitissimpleandsafeandhasahighcost-benefitratio. 2-4 In the absence of right ventricular outflow tract obstruction, tricuspid regurgitation velocity measured by Doppler ultra- sound can be used to estimate the pulmonary artery systolic pressures. 5,6 In addition, echocardiography enables visualiza- tionoftherightatrialandventricularsizesandtheinferiorvena cava inspiratory collapse which are all essential in accurately measuring pulmonary pressure .1,5,9 Thus, echocardiography is important for the initial evaluation of pulmonary hypertension prior to right heart catheterization when indicated to confirm the diagnosis of suspected cases. 7,8 Pulmonary hypertension in children presents initially with subtle signs and symptoms which makes early diagnosis difficult.Thus,affectedchildrenpresentlatewithcomplications which usually leads to mortality within a year of diagnosis. 9,10