Hypertension in childhood

Hypertension is seen in 1-2% of children. It is multifactorial in origin. An analysis of 245 children with hypertension seen in 3 years in the Southern Railway Hospital, Madras is presented. In this series, all cases are secondary to some underlying causes. The so called "Benign Essential Hypertension" is not so uncommon in children but the authors have not had a case til now. In more than 80% of the cases, it is due to acute glomerulonephritis where hypertension is temporary. 8% of all the cases can be cured by surgery (If acute glomerulonephritis is excluded, this forms 50%). In another 8%, hypertension is permanent. Routine measurement of blood pressure in all children during physical examination is essential to detect the cases early. Extensive investigations are necessary to diagnose the cause in some cases. Three typical case histories are presented. Hypertensive crisis is an emergency and should be managed by intensive medical care. Today, even in India, various sophisticated investigations can be done for the detection of the cause, and surgical treatment including cardiac surgery can be done, aggressive medical treatment can be given with the availability of all anti-hypertensive drugs, and so the paediatricians and paediatric surgeons must diagnose the cases early and institute appropriate treatment.