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Arterial hypertension in children
Maristella Santi1, Barbara Goeggel Simonetti, Corinna F P Leoni-Foglia
1aPediatric Department of Southern Switzerland, Bellinzona bDepartment of Neurology cDivision of Pediatric Nephrology, Department of Pediatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
Insights
Childhood hypertension is rising, impacting long-term cardiovascular health. Early detection and improved therapies are crucial for managing this growing concern in children and adolescents.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Public Health
Background:
- Childhood hypertension is increasingly prevalent, linked to the childhood overweight epidemic.
- Cardiovascular development in childhood influences adult cardiovascular health.
- Growing concern exists regarding elevated blood pressure (BP) in pediatric populations.
Purpose of the Study:
- To review and discuss emerging aspects of childhood hypertension.
- To highlight the significance of early cardiovascular health tracking into adulthood.
Main Methods:
- Review of current guidelines and expert opinions on pediatric BP screening.
- Analysis of sophisticated approaches investigating sympathetic nervous system modulation in childhood hypertension.
Main Results:
- US Preventive Services Task Force found insufficient evidence for routine BP screening benefits in children.
- Expert opinion supports BP assessment as part of routine physical examinations.
- Sympathetic nervous system overdrive plays a role in childhood arterial hypertension.
Conclusions:
- Elevated BP in children has significant short- and long-term health consequences.
- Addressing childhood overweight may reduce hypertension incidence.
- Advanced therapies offer potential for preventing or mitigating early cardiovascular disease in affected children.
Purpose Of Review:
Although arterial hypertension is less common in children than in adults, there is growing concern about elevated blood pressure (BP) in children and adolescents not only because of the association of elevated values with the overweight epidemic, but also as cardiovascular functions are determined in childhood and track into adulthood. The purpose of the review is to discuss new aspects of childhood hypertension.
Recent Findings:
Guidelines advocate determining BP in children as part of routine health maintenance. This recommendation was recently subject to review by the US Preventive Services Task Force. It was concluded that evidence is insufficient to assess the benefits of this screening. In our opinion, however, assessing BP is part of any thorough physical examination.Sophisticated approaches demonstrate the role of sympathetic nervous system overdrive in the field of sympathetic cardiovascular modulation of childhood arterial hypertension.
Summary:
Elevated BP in children is increasing in frequency and is now recognized as having relevant short-term and long-term consequences. Although efforts to address the childhood overweight epidemic may eventually reduce the number of young patients with hypertension, improved therapies for childhood hypertension also offer the potential for preventing or ameliorating early cardiovascular disease.
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