[High blood pressure in obese children and adolescents]

Obesity is also an important risk factor in children and adolescents for "essential" arterial hypertension, and contrary to what was assumed earlier, high blood pressure does cause damage to the cardiovascular system. As known from adults, elevated blood pressure induces cardiac hypertrophy, calcifications and atherosclerosis at the coronary vessels and thickens the small blood vessels. These early vascular alterations are particularly pronounced, when increased blood pressure is accompanied by other risk factors, such as dyslipidemia, hyperinsulinemia or smoking. As in any child with elevated blood pressure, the diagnostic evaluation should focus on confirmation of hypertension, determine if an underlying cause can be identified and whether hypertensive target organ damage is present. New reference office blood pressure values were recently published by a large representative community-based study in Germany. Therapy should begin with lifestyle modifications; however, antihypertensive medications will often be needed. Hypertension in obese adolescents occurs frequently and must be diagnosed and treated adequately.