Hypertension in Children: A Single Center Experience (original) (raw)
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Diagnosis and Treatment of Hypertension in Children
Current Hypertension Reports, 2010
Hypertension is a global problem, affecting both developed and developing nations. In children and adolescents, hypertension has gained ground in cardiovascular medicine, thanks to the progress made in several areas of pathophysiologic and clinical research. Childhood hypertension is often asymptomatic and is easily missed, even by health professionals. Target organ damage is detectable in children and adolescents. Management of hypertension includes lifestyle changes and pharmacologic treatment. In the case of secondary hypertension, pharmacologic treatment usually is required. In essential hypertension, assessment of early organ damage provides a useful tool for treatment decisions.
Arterial Hypertension in Children and Adolescents: state of the art (Atena Editora)
Arterial Hypertension in Children and Adolescents: state of the art (Atena Editora), 2022
Hypertension in childhood and adolescence is a major concern, due to the increasing prevalence and evidence that suggests that adult hypertension has its genesis in childhood. In 2015, high blood pressure was the leading modifiable risk factor for cardiovascular, cerebrovascular, and kidney disease and the largest contributor to global disability-adjusted life years (DALYs) worldwide. Diagnosing high blood pressure in children and adolescents remains challenging due to high rates of false high blood pressure readings at a single visit despite clear guidelines. Our aim is to provide an overview of the state of the art on primary-cause arterial hypertension in children and adolescents, highlighting the definition, prevalence, risk factors, diagnosis and treatment. This is an integrated bibliographic review of the scientific production on arterial hypertension in children and adolescents. The search for articles was carried out with the terms ‶Hypertension″, ‶Children″ and ‶Adolescents″ in English and Portuguese, in the VHL databases, with the following search details: (mh:("Hypertension")) AND children AND adolescents AND ( db:("MEDLINE" OR "BINACIS" OR "LILACS" OR "IBECS" OR "CUMED" OR "MedCarib") AND mj:("Hypertension") AND type_of_study:("systematic_reviews" OR "prevalence_studies" OR " diagnostic_studies") AND la:("en" OR "pt")) AND (year_cluster:[2017 TO 2022]). The Google Academic and Pubmed databases were used in parallel, and 36 articles published from 2017 to 2022 were selected. growth and development, lifestyle changes and results in hypertension in the first two decades of life.
Study of Clinico-Aetiological Factors of Paediatric Hypertension in a Tertiary Care Centre
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Hypertension is a public health challenge for societies, not only in adults, but also in children in socioeconomic and epidemiological transition and one of the most important risk factors for cardiovascular death accounting for 20-50% of all deaths. This study was done to screen all hospitalised children and outpatient clinic children in the age group of 1-14 years and find out those who were hypertensive and establish the aetiology and clinical features. MATERIALS AND METHODS Blood pressure was measured in children making 2 study groups. Study group 1 (3754 hospitalised children) and study group 2(820 outpatient clinic children) in the age group of 1-14 years. Children who were detected to be having hypertension were evaluated by proper history, clinical examination and necessary investigations. Children below 1 year were excluded from the study. RESULTS Secondary hypertension (80 (98.76%)) was common in children. Among the causes of secondary hypertension, renal parenchymal disease (64 (79.01%)) was the predominant aetiology. Prevalence of hypertension in our study 2.7%, prevalence of essential hypertension is 1% and prevalence of secondary hypertension is 1.7%. CONCLUSION Systemic hypertension is uncommon in infancy and childhood, but whenever present is usually indicative of an underlying process (secondary hypertension). In contrast, adolescents develop primary or essential hypertension with no underlying cause. Accurate blood pressure measurement should be a part of routine physical examination of all children and at least of that more than 1 year of age.
[Target organ damage in children with newly diagnosed and untreated essential hypertension]
Przegla̧d lekarski, 2006
Target organ damage in the course of essential hypertension (EH) may develop already in childhood. The aim of the study was to determine the prevalence of left ventricular hypertrophy (LVH) and arterial damage and its main determinants in children with newly diagnosed, untreated EH. PATIENTS (pts): 87 children (22 girls and 65 boys) with EH, age 14.4 +/- 3 (5-18) yrs. 104 healthy children (51 girls and 53 boys) aged 13.3 +/- 3.3 (5-20) yrs. cross-sectional, controlled study. evaluation of anthropometrical data, birth weight, family history towards cardiovascular diseases, serum biochemical cardiovascular risk factors (lipids, sCRP, homocysteine, uric acid), carotid (cIMT) and superficial femoral artery intima-media thickness (fIMT). In EH children ambulatory blood pressure monitoring (ABPM), echocardiography, ophthalmoscopy, microalbuminuria were evaluated. EH pts were significantly higher, heavier and had greater body mass index (BMI) (p<0.05). 59% of pts were overweight compare...
Clinical and Demographic Characteristics of Children With Hypertension * Novelty and Significance
Hypertension, 2012
F ew contemporary data are available that provide an accurate description of the clinical and demographic characteristics of hypertensive children and adolescents. Most recent studies have been retrospective, single-center reports from referral centers that focus on highlighting specific aspects of the referred patient populations. 1-4 Even the available multicenter data 5 are affected by referral bias, small sample size, and other issues that limit the conclusions that can be drawn about hypertensive children in general. Two multicenter studies of the efficacy and safety of valsartan in hypertensive children and adolescents were conducted by Novartis Pharmaceuticals in the late 2000s. 6,7 In this report we have pooled the baseline clinical and demographic data on the subjects enrolled in those trials to better describe the characteristics of such patients in the current era. Methods Study Design This analysis of demographic and clinical characteristics of children with hypertension was conducted using data from 2 randomized, doubleblind, multicenter valsartan trials sponsored by Novartis Pharmaceuticals. Study A2307 6 was performed at 36 centers in 7 countries, and Study A2302 7 was performed at 55 centers in 9 countries. Institutional review boards/ethics committees at each participating center reviewed and approved the study protocols; written informed consent/assent was obtained for all of the study participants according to local requirements. Subjects Detailed inclusion and exclusion criteria for the 2 trials have been published previously. 6,7 Study A2307 enrolled children aged <6 years with seated systolic blood pressure (BP; SBP) ≥95th percentile for age, sex, and height 8 who were not receiving antihypertensive treatment or who had inadequately controlled hypertension on current treatment. Minimum patient weight was 8 kg. Key
Control of hypertension in treated children and its association with target organ damage
American journal of hypertension, 2012
The aim of our study was to investigate the control of hypertension (HT) in treated children using ambulatory blood pressure (BP) monitoring (ABPM). We retrospectively reviewed all ABPM studies in our center. Controlled HT was defined as systolic and diastolic BP index (patients' BP divided by the 95th percentile) at daytime and nighttime <1.0 or alternatively as BP load (percentage of BP readings above the 95th percentile) <25% in children on antihypertensive therapy. A total of 195 ABPM studies were included. The mean age was 13.6 ± 4.0 years. One hundred and thirty two children had renoparenchymal HT, 10 renovascular (RVH), 10 endocrine, 4 cardiovascular, 29 primary (PH) and 5 children other forms of HT. 53% of all children had controlled HT. There was no difference in the prevalence of controlled HT between primary and secondary HT (52% and 53%) using the BP index criterion. Children with renoparenchymal HT had significantly better control of HT than children with RVH ...
Prevalence and risk factors associated with hypertension among children and adolescents
International Journal of Current Advanced Research
Hypertension has been identified as the leading risk factor for mortality, and is ranked third as a cause of disability life-years [1]. According to WHO (2002), the number of people worldwide afflicted with hypertension was about 600 million[2].The hospitalization rate for children and adolescents with a diagnosis of hypertension during 1997 2006, doubled from approximately 18 cases per 100,000 paediatric hospital discharges in 1997 to approximately 35 cases per 100,000 in 2006. Among children and with hypertension, as many as one in three has target organ damage, especially left ventricular hypertrophy [3]. Various factors might have attributed to this rising trend like changing life style, diet and urbanization. Blood pressure normally changes with growth and development. So, it becomes increasingly important to detect and interrupt development of
High Blood Pressure & Cardiovascular Prevention, 2019
High blood pressure (BP) is becoming a growing health issue even in children and adolescents. Moreover, BP elevation in youth frequently translates into children and adult hypertension contributing to the development of cardiovascular disease. The detection of early markers of vascular damage, potentially leading to overt cardiovascular disease, is important for clinical decisions about if and how to treat hypertension and can be useful in monitoring the effectiveness of the treatment. The purpose of this review is to summarize the actual knowledge about subclinical organ damage (SOD) in hypertensive children and adolescents and its association with cardiovascular disease in children and young adults. Our focus is especially put on left ventricular mass, pulse wave velocity, carotid intima-media thickness and microalbuminuria. We also want to address the scientific evidence about possible regression of SOD and cardiovascular risk with the use of behavioural and specific anti-hypertensive therapy. Indications from current guidelines are critically discussed.
Pediatric hypertension: an updated review
Clinical Hypertension
Globally hypertension in adults is among the leading preventable cause of premature death, where a graded association from the childhood hypertension is well recognised. With the concurrent rise in obesity and pediatric hypertension (HTN) during the past decade in developed countries, a parallel trend is emerging in developing countries that has a potential for exponential rise in cardiovascular, cerebrovascular and renal tragedies. A cumulative incidence of pediatric HTN in China and India is 50–70 and 23% respectively, is quite disturbing. New guidelines for the detection, evaluation and management of hypertension in children and adolescents published in 2017, where a jump in prevalence of pediatric HTN is observed, rings a call to address this under-attended burning problem; for which a review in pediatric hypertension and its management is warranted.