[New aspects of hypertension in the child and adolescent]

Current issues in pediatric hypertension are discussed in the light of an international symposium held in Heidelberg in 1985. Well designed long-term studies on blood pressure changes in children including new physiological findings and non-invasive diagnostic methods are the basis for a critical evaluation of childhood hypertension. Primary (or essential) hypertension now is regarded as a diagnostic entity partly due to a genetic background and defined by certain pathophysiological changes. Its clinical significance and especially its long-term effects into adult life are yet to be determined in detail. Secondary forms of hypertension have recently involved pediatric nephrologists, endocrinologists and cardiologists. Other fields involved in the research of childhood hypertension include human genetics, radiology and clinical pharmacology. The review is followed by a suggestion of guidelines for future research in pediatric hypertension. The appendix contains recommendations for the management of hypertension in children and adolescents issued by an International Committee.