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Hypertension in children and adolescents: epidemiology and pathogenesis

Manu Raj1, R Krishnakumar

  • 1Division of Pediatric Cardiology, Amrita Institutes of Medical Sciences and Research Centre, Kochi, Kerala, India. drmanuraj@gmail.com

Indian Journal of Pediatrics
|September 4, 2012
PubMed

Insights

High blood pressure (hypertension) in children poses significant long-term health risks, often leading to adult hypertension. Understanding its causes and epidemiology is crucial for early intervention and prevention strategies.

Area of Science:

  • Pediatric Cardiology
  • Public Health
  • Nephrology

Background:

  • High blood pressure is a major global health burden, contributing significantly to stroke and ischemic heart disease.
  • Limited data exists on the long-term outcomes of childhood hypertension, despite substantial suspected health risks.
  • Childhood hypertension is linked to adult hypertension, highlighting the importance of pediatric health surveillance.

Purpose of the Study:

  • To review the epidemiology of hypertension in children.
  • To explore the multifactorial causes of essential (primary) hypertension in pediatric populations.
  • To identify age-dependent causes of secondary hypertension in children.

Main Methods:

  • Review of epidemiological studies on childhood hypertension across continents.
  • Analysis of factors influencing blood pressure distribution and hypertension prevalence in children.
  • Compilation of etio-pathogenetic factors for essential and secondary hypertension in pediatric patients.

Main Results:

  • Epidemiology of childhood hypertension is well-documented, influenced by measurement methods, socio-demographics, adiposity, and ethnicity.
  • Essential hypertension pathogenesis is multifactorial, involving obesity, insulin resistance, sympathetic nervous system activation, and genetic factors.
  • Secondary hypertension causes vary by age: renal disorders and coarctation of the aorta in younger children; renal parenchymal disease in older children.

Conclusions:

  • Childhood hypertension has substantial long-term health implications, including progression to adult hypertension.
  • Understanding the diverse etio-pathogenesis of primary and secondary hypertension is vital for effective pediatric management.
  • Further research is needed to address the deficiency in data regarding long-term outcomes of hypertension in children.

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