Pediatric hypertension has been recognized as an important health issue over the past years. In children though the etiology of hypertension is predominantly secondary, the prevalence of primary hypertension has been increasing at an alarming rate, particularly in adolescents and older children.
Discussion
The prevalence of hypertension in children increases with increasing body mass index percentile, placing obese children at three times higher risk of becoming hypertensive. It has been shown that weight loss by itself can decrease blood pressure and other associated cardiovascular risk factors should also be expected to regress or improve with weight loss. Dietary changes can involve portion-size control, decrease in consumption of sugar-containing beverages, energy-dense snacks, increase in consumption of fresh fruits, vegetables, low-fat dairy, stopping smoking and abstinence from alcohol use. Secondary hypertension due to specific conditions can be controlled and treated successfully by appropriate timely interventions both surgical and nonsurgical.
Conclusion
Pediatric hypertension is a serious disease that should be neither overlooked nor ignored. The evaluation and treatment of hypertension in childhood has continued to evolve over the past four decades. There is a great need to diagnose and treat hypertension when it develops in childhood to decrease the risk of cardiovascular morbidity in adulthood.
How to cite this article
Vijayalakshmi IB, Narasimhan C. Hypertension in Children and Adolescents. Hypertens J 2015;1(2):88-93.
Evaluation and management of hypertension. Ind Pediatr 2007;44(2):103-121.
Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009;27(9):1719-1742.
The Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555-576.
Hypertension screening in schools: results of the Dallas study. Pediatrics 1979;63(1):32-36.
Prevalence of ‘significant’ hypertension in junior high school-aged children: the children and adolescent blood pressure program. J Pediatr 1989;114(4 Pt 1):664-669.
Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004;113(3Pt 1):475-482.
Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002;40(4):441-447.
Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 2007;150(6):640-644,644.e1.
High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007;116(13):1488-1496.
Hypertension in children and adolescents: epidemiology and pathogenesis. Ind J Pediatr 2013;80(Suppl 1):S71-S76.
Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987;79(1):1-25.
Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311(5):507.
Blood pressure nomograms for children and adolescents, by height, sex, and age, in the United States. J Pediatr 1993;123(6):871.
Ambulatory blood pressure monitoring in children and adolescents: coming of age? Curr Hypertens Rep 2013;15(3):143-149.
Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the council on cardiovascular disease in the young and the council for high blood pressure research. Hypertension 2008;52(3):433-451.
Pediatric approach to hypertension. Semin Nephrol 2009;29(4):379-388.
The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289(19):2560-2572.
Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992;20(5):1251-1260.
Physical activity and incidence of hypertension in college alumni. Am J Epidemiol 1983;117(3):245-257.
Hypertension in children: an update on treatment strategies. Curr Opin Pediatr 2007;19(2):170-177.
Therapeutic options for the treatment of hypertension in children and adolescents. Clin Med Insights Circ Respir Pulm Med 2012;6:13-25.
Interventions for pediatric renovascular hypertension. Curr Hypertens Rep 2014;16(4):422.
Complete renal embolization as an alternative to nephrectomy. J Urol 1999;161(1):24-27.
Renal artery coil embolization of a non-functional kidney: a novel method to treat resistant hypertension in paediatric patients. J Ind College Cardiol 2015;5(3):231-234.
Recent advances in management in of non-specific aorto arteritis. Ind J Pediatr 2002;69(6):523-526.
