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Pediatric approach to hypertension

Tammy M Brady1, Leonard G Feld

  • 1Division of Pediatric Nephrology, Johns Hopkins Hospital, 200 North Wolfe Street, Baltimore, MD 21287, USA. tbrady8@jhmi.edu

Seminars in Nephrology
|July 21, 2009
PubMed

Insights

Pediatric hypertension (HTN) is rising, necessitating early detection and management. Secondary causes must be excluded in children diagnosed with HTN, with treatment including lifestyle changes and medication when needed.

Area of Science:

  • Pediatric Cardiology
  • Public Health
  • Nephrology

Background:

  • Pediatric hypertension (HTN) prevalence has significantly increased.
  • This rise leads to more children experiencing hypertensive sequelae and contributes to adult HTN.
  • Increased HTN in children presents a growing public health concern requiring vigilant management.

Purpose of the Study:

  • To emphasize the need for thorough screening, diagnosis, evaluation, and treatment of pediatric HTN.
  • To highlight the importance of excluding secondary causes of HTN in children.
  • To outline diagnostic and therapeutic strategies for managing childhood HTN.

Main Methods:

  • Review of diagnostic work-up for pediatric hypertension.
  • Identification of common secondary causes of HTN in children (renal, renovascular, endocrine, genetic).
  • Guidelines for therapeutic lifestyle changes and pharmacologic treatment.

Main Results:

  • Primary HTN is increasingly common in children but should be a diagnosis of exclusion.
  • Secondary causes of HTN are more likely in younger children and with severe BP elevation.
  • Genetic disorders can cause severe, early-onset HTN.

Conclusions:

  • All children with HTN require therapeutic lifestyle changes.
  • Medication is indicated for symptomatic, secondary, severe, resistant HTN, or end-organ damage.
  • Prompt diagnosis and management are crucial for preventing long-term complications.

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