Hypertension and vascular health in the young

This review examines the role of vascular health in children and adolescents with systemic hypertension. Like other areas of target organ damage (TOD), arterial dysfunction can have deleterious effects over time, leading to adverse cardiovascular events such as myocardial infarction or stroke as an adult.

Literature in the last few years has focused on TOD to the vascular tree in pediatric patients with hypertension. These data also included vascular dysfunction in ambulatory and masked hypertension, particularly in secondary causes of hypertension, which emphasize the importance of ambulatory BP monitoring in these patients. While subclinical TOD exists early on, longitudinal studies that follow diverse populations with hypertension from childhood into late adulthood are needed to determine if abnormal vasculature is independently associated with suboptimal cardiovascular outcomes. Consistent conduct of these tests would more formally incorporate them into pediatric clinical practice.

Hypertension is a chronic medical condition that needs a multipronged treatment approach. The vasculature is an important yet understudied area of TOD. Longitudinal studies in this realm could link subclinical disease in youth to adult adverse events and develop more precise management to mitigate these events and to enable a better quality of life.