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Systolic hypertension in children: benign or beware?

J M Sorof1

  • 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
PubMed

Insights

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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