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Management of systemic hypertension in children and adolescents: an update

Mark C Johnson1, Cortney J Schneider, Anne M Beck

  • 1Pediatric Cardiology, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116-NWT, St. Louis, MO 63110, USA. Johnson_m@kids.wustl.edu

Current Treatment Options in Cardiovascular Medicine
|September 28, 2007
PubMed

Insights

Pediatric hypertension management is crucial for preventing future cardiovascular disease. Early identification and treatment, including lifestyle changes and medication, can decrease long-term risks in children.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Public Health

Background:

  • Hypertension in children is an emerging health concern with potential long-term cardiovascular implications.
  • Establishing a definitive link between childhood hypertension and adult cardiovascular disease risk is essential.
  • Addressing associated risk factors like obesity and dyslipidemia is critical for comprehensive management.

Purpose of the Study:

  • To outline current strategies for the identification and management of hypertension in pediatric populations.
  • To emphasize the importance of early intervention in reducing future cardiovascular morbidity and mortality.
  • To provide guidance on pharmacologic and non-pharmacologic treatment approaches based on hypertension severity and specific conditions.

Main Methods:

  • Review of current guidelines and evidence for pediatric hypertension diagnosis and treatment.
  • Discussion of lifestyle modifications, pharmacotherapy indications, and interventional procedures.
  • Consideration of specific pediatric hypertension etiologies, including coarctation of the aorta and renal artery stenosis.

Main Results:

  • Lifestyle modifications are recommended for all pediatric hypertension patients, particularly those with blood pressure between the 95th and 99th percentiles.
  • Pharmacologic therapy is indicated for severe hypertension ( > 99th percentile), secondary hypertension, or when lifestyle changes fail.
  • Interventional treatments like angioplasty or surgery are options for specific conditions such as renal artery stenosis and coarctation of the aorta.

Conclusions:

  • Consistent identification and treatment of pediatric hypertension are vital for long-term cardiovascular health.
  • Tailored treatment strategies, including lifestyle changes, medication, and interventions, are necessary for optimal outcomes.
  • Further long-term studies are needed to solidify the link between childhood hypertension treatment and reduced adult cardiovascular disease.

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