Pathophysiology of hypertension in obese children: a systematic review

Area of Science:

• Pediatric Endocrinology
• Cardiovascular Physiology
• Obesity Medicine

Background:

• Pediatric hypertension is a growing concern, particularly in overweight and obese children.
• The underlying mechanisms linking obesity to hypertension in children are not fully understood.
• Effective treatment requires a deeper insight into the pathophysiology of hypertension in this population.

Purpose of the Study:

• To review and summarize key factors associated with hypertension in obese children.
• To discuss the potential roles of these factors in the pathophysiology of pediatric hypertension.
• To highlight the need for further research into the complex mechanisms involved.

Main Methods:

• Systematic literature searches were performed in PubMed and EMBASE up to October 2014.
• Included 60 relevant studies with varying methodological quality.
• Synthesized findings on factors contributing to hypertension in obese children.

Main Results:

• Identified several contributing factors: endocrine determinants (corticosteroids, adipokines), sympathetic nervous system activity, disturbed sodium homeostasis, oxidative stress, inflammation, and endothelial dysfunction.
• These factors are suggested to play a role in the development of hypertension in obese children.
• Current evidence, primarily from cross-sectional studies, limits causal inference.

Conclusions:

• Understanding the pathophysiology of hypertension in overweight and obese children is crucial for screening and treatment strategies.
• High-quality longitudinal studies are necessary to elucidate the complex causal pathways.
• Further research is essential to address the rising prevalence of pediatric hypertension linked to obesity.