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Control of hypertension in treated children and its association with target organ damage

Tomáš Seeman1, Lukáš Dostálek, Jiří Gilík

  • 1Department of Pediatrics, University Hospital Motol, Charles University Prague, Second Medical School, Prague, Czech Republic. tomas.seeman@lfmotol.cuni.cz

American Journal of Hypertension
|November 18, 2011
PubMed

Insights

Nearly half of treated children have uncontrolled hypertension (HT), indicating inadequate management. This poor blood pressure (BP) control is linked to target organ damage in pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Hypertension Management

Background:

  • Hypertension (HT) in children requires effective management.
  • Ambulatory blood pressure (BP) monitoring (ABPM) is a key tool for assessing BP control.

Purpose of the Study:

  • To investigate the control of hypertension in treated children using ambulatory blood pressure monitoring (ABPM).

Main Methods:

  • Retrospective review of 195 ABPM studies in children on antihypertensive therapy.
  • Controlled HT defined by BP index <1.0 or BP load <25%.
  • Analysis of HT causes, treatment efficacy, and target organ damage.

Main Results:

  • 53% of children achieved controlled HT.
  • Renoparenchymal HT showed better control than renovascular HT (58% vs. 20%).
  • Angiotensin-converting enzyme inhibitors (ACEI) monotherapy was more effective than calcium-channel blockers (CCB).
  • Uncontrolled HT was associated with higher rates of left ventricular hypertrophy (46% vs. 13%).

Conclusions:

  • This study highlights inadequate hypertension control in approximately 50% of treated pediatric patients.
  • Poor BP control in children is associated with target organ damage.
  • This is the first pediatric study using ABPM to assess BP control in hypertensive children.
Abstract

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