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Intersection of Pediatric Hypertension and Cardiovascular-Kidney-Metabolic Disease

Jessica O'Keeffe1, Christina Kingshill2,3,4, Jack Tompson5

  • 1Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.

Current Hypertension Reports
|June 23, 2026
PubMed

Insights

Pediatric hypertension and cardiovascular-kidney-metabolic syndrome (CKM) are prevalent. Addressing early life factors and social determinants is key to managing CKM and hypertension in children.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Metabolic Disorders

Background:

  • Cardiovascular-kidney-metabolic syndrome (CKM) is increasingly recognized in children.
  • Antenatal factors, including maternal hypertension, influence CKM onset.
  • Social determinants of health significantly impact CKM progression and childhood obesity.

Purpose of the Study:

  • To delineate the relationship between pediatric hypertension and CKM.
  • To understand the progression of CKM in pediatric populations.
  • To identify key mediators and influencing factors in CKM development.

Main Methods:

  • Literature review on pediatric hypertension and CKM.
  • Analysis of factors influencing CKM staging.
  • Examination of the role of the renin-angiotensin-aldosterone system.

Main Results:

  • CKM is highly prevalent in children, influenced by antenatal risks and social determinants.
  • Hypertension exacerbates CKM staging and increases atherosclerotic cardiovascular disease risk.
  • Early life nutrition and social factors are critical for CKM and hypertension management.

Conclusions:

  • Early intervention targeting hypertension and CKM is crucial.
  • Addressing food insecurity and social determinants improves outcomes.
  • Integrated management strategies are essential for pediatric CKM and hypertension.
Abstract

Keywords:
AAP, american academy of pediatricsABPM, ambulatory blood pressure monitoringACEi, angiotensin-converting enzyme inhibitorAHA, american heart associationARB, angiotensin II receptor blockerASCVD, atherosclerotic cardiovascular diseaseBAT, brown adipose tissueBNP, brain natriuretic peptideCHD, congenital heart diseaseCKD, chronic kidney diseaseCKM, cardiovascular-kidney-metabolic syndromeCPG, clinical practice guidelineCRS, cardiorenal syndromeDASH, dietary approaches to stopping hypertensionDOHaD, developmental origins of health and diseaseEGF, epidermal growth factorER, endoplasmic reticulumFFA, free fatty acidsGFR, glomerular filtration rateHTG, hypertriglyceridemiaIL-18, interleukin-18KIM-1, kidney injury molecule-1MAP, mean arterial pressureNGAL, neutrophil gelatinase-associated lipocalinNHANES, national health and nutrition examination surveyNT-proBNP, N-terminal pro-B-type natriuretic peptidePAI-1, plasminogen activator inhibitor 1PVAT, perivascular adipose tissueRAAS, renin-angiotensin-aldosterone systemROS, reactive oxygen speciesSGLT2, sodium-glucose co-transporter 2 protein inhibitorSNS, sympathetic nervous systemSRP, negative social risk profileT2DM, type 2 diabetes mellitusTG, triglyceridesTNFR-1, -2, tumor necrosis factors1 and 2UACR, urine albumin-creatinine ratioVSMC, vascular smooth muscle cellWAT, white adipose tissueWCH, white coat hypertension

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