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Hypertension Canada's 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric
Janis M Dionne1, Kevin C Harris2, Geneviève Benoit3
1Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
This study provides evidence-based guidelines for preventing and treating pediatric hypertension, focusing on lifestyle and drug therapy. These guidelines offer primary care practitioners crucial information for managing high blood pressure in children.
Area of Science:
- Pediatric Cardiology
- Clinical Guidelines
- Public Health
Background:
- The 2016 guidelines addressed pediatric hypertension diagnosis and investigation.
- There was a need for updated evidence-based guidelines for prevention and treatment in children.
Purpose of the Study:
- To present evidence-based guidelines for the prevention and treatment of hypertension in children.
- To provide guidance for primary care practitioners on managing pediatric hypertension.
Main Methods:
- Development by Hypertension Canada's Guideline Committee pediatric subgroup.
- Thorough evaluation of available literature on pediatric hypertension.
- Inclusion of 10 guidelines covering health behavior, drug therapy indications, and treatment goals.
Main Results:
- Guidelines address health behavior management and indications for drug therapy.
- Recommendations cover the choice of therapy for primary hypertension and treatment goals.
- Acknowledges limitations in pediatric literature (small numbers, fewer trials).
Conclusions:
- These guidelines represent the current highest level of evidence for pediatric hypertension management.
- Therapeutic lifestyle modifications and newer antihypertensive drugs are considered.
- Guidelines will be annually reviewed and updated, with algorithm tools to be developed.
Abstract:
After the 2016 guidelines for blood pressure measurement, diagnosis, and investigation of pediatric hypertension, we now present evidence-based guidelines for the prevention and treatment of hypertension in children. These guidelines were developed by Hypertension Canada's Guideline Committee pediatric subgroup after thorough evaluation of the available literature. Included are 10 guidelines specifically addressing health behaviour management, indications for drug therapy in children with hypertension, choice of therapy for children with primary hypertension, and goals of therapy for children with hypertension. Although the pediatric literature is inherently limited by small numbers of participants, fewer trials, and a prolonged latency to the development of vascular outcomes, this report reflects the current and highest level of evidence and provides guidance for primary care practitioners on the management of pediatric hypertension. Studies of therapeutic lifestyle modifications in children are available to guide current management and more antihypertensive drugs have been studied in children since the Food and Drug Administration Modernization Act. Consistent with Hypertension Canada's guideline policy, diagnostic and therapeutic algorithm tools will be developed and the guidelines will be reviewed annually and updated according to new evidence.
