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Systolic hypertension in children: benign or beware?
1Division of Pediatric Nephrology and Hypertension, University of Texas-Houston, Medical School, Room 3.124, 6431 Fannin Street, Houston, TX 77030, USA. jonathan.m.sorof@uth.tmc.edu
Pediatric Nephrology (Berlin, Germany)
|June 26, 2001
Summary
Systolic blood pressure (SBP) elevation is a significant factor in pediatric hypertension, impacting heart health. Focusing on normalizing SBP is crucial for treating hypertension in children, even if diastolic blood pressure is normal.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Cardiovascular Health
Background:
- Systolic blood pressure (SBP) is the primary metric for adult hypertension diagnosis and treatment.
- Emerging data highlight SBP elevation's critical role in pediatric hypertension morbidity, mirroring adult trends.
- SBP hypertension is prevalent in children, detected through routine screening and in referred hypertensive patients.
Purpose of the Study:
- To emphasize the importance of systolic blood pressure (SBP) in pediatric hypertension.
- To advocate for SBP normalization as the primary treatment goal in children.
- To suggest the inclusion of SBP hypertension in pediatric anti-hypertensive medication trials.
Main Methods:
- Review of epidemiological and pathophysiological data on adult and pediatric hypertension.
- Analysis of studies linking blood pressure levels to cardiovascular changes in children.
- Examination of the relationship between SBP, diastolic blood pressure (DBP), and left ventricular mass (LVM) in pediatric populations.
Main Results:
- Mild-to-moderate blood pressure elevation in children is associated with increased left ventricular mass (LVM).
- SBP shows a stronger correlation with left ventricular morphology than DBP in children.
- Increased LVM is observed even in children with SBP within the "normal" range.
Conclusions:
- Treatment of pediatric hypertension should prioritize SBP normalization, irrespective of DBP levels.
- Left ventricular hypertrophy (LVH) in hypertensive children is more strongly related to SBP than DBP.
- Future anti-hypertensive medication trials in children must include SBP hypertension criteria.
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