Abnormalities of vascular structure and function in pediatric hypertension

Urbina, Elaine M.

doi:10.1007/s00467-015-3188-1

Cited by 37 publications

(24 citation statements)

References 86 publications

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“…Grade (eg, stroke, myocardial infarction, etc), 69 and FMD, which assesses endothelial function and describes the ability of the endothelium to release nitric oxide in response to stress. 375 Although there are multiple large studies of PWV in youth, 376 -381 they all suffer from notable limitations, primarily the lack of racial and ethnic diversity and differences in measurement devices and protocols. Researchers in the largest study of PWV in youth to date (N = 6576) only evaluated 10 and 11 year olds and measured only carotid-radial PWV across the arm; this measure has not been linked to CV events in adults.…”

Section: Aggregate Evidence Qualitymentioning

confidence: 99%

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

et al. 2017

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These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.

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Section: Aggregate Evidence Qualitymentioning

confidence: 99%

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

et al. 2017

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“…Several mechanisms link obesity and high blood pressure, including upregulation of pro‐inflammatory adipokines due to adipose tissue dysfunction, increased sympathetic nervous system, abnormal kidney function associated with increased tubular sodium reabsorption, and increasing arterial stiffness 25‐31 . It has also been hypothesized that obesity‐related changes in the composition and function of gut microbiota might be associated with hypertension 32 .…”

Section: Discussionmentioning

confidence: 99%

“…Results from our study suggest that the prevention of central obesity may play an important role in the prevention of hypertension in adolescents and young adults with type 1 or type 2 diabetes. This may prevent obesity‐related metabolic changes involved in the development of hypertension 25‐31 . However, previous analyses also showed that microvascular complications of diabetic kidney disease, retinopathy, and peripheral neuropathy were higher among youths and young adults with type 2 diabetes compared to those with type 1 even after adjustment for central obesity, glycemic control, and other factors over time 6 .…”

Section: Discussionmentioning

confidence: 99%

Progression to hypertension in youth and young adults with type 1 or type 2 diabetes: The SEARCH for Diabetes in Youth Study

Koebnick

Imperatore

Jensen

et al. 2020

J of Clinical Hypertension

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Central obesity may contribute to the development of hypertension in youths with diabetes. The SEARCH for Diabetes in Youth Study followed 1518 youths with type 1 diabetes (T1D) and 177 with type 2 diabetes (T2D) diagnosed when <20 years of age for incident hypertension. Incident hypertension was defined as blood pressure ≥95th percentile (or ≥130/80 mm Hg) or reporting antihypertensive therapy among those without hypertension at baseline. Poisson regression models were stratified by diabetes type and included demographic and clinical factors, clinical site, and waistto-height ratio (WHtR). Youths with T2D were more likely to develop hypertension than those with T1D (35.6% vs 14.8%, P < .0001). For each 0.01 unit of annual increase in WHtR, adjusted relative risk for hypertension was 1.53 (95% CI 1.36-1.73) and 1.20 (95% CI 1.00-1.43) for youths with T1D and T2D, respectively. Effective strategies targeted toward reducing central obesity may reduce hypertension among youths with diabetes.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. ET Jensen, JM Stafford, and RB D'Agostino, Jr. performed statistical analysis. D Dabelea, RB D'Agostino, Jr., and JM Lawrence obtained funding. | 895 KOEBNICK Et al.

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“…Vasculatura: A pesar de que aún su uso no es rutinario, es importante considerar evaluación de la estructura y función vascular a través de pruebas no invasivas, ya que estudios han demostrado daño ateroesclerótico precoz en adolescentes hipertensos 1,11 . Estas pruebas incluyen: -Función endotelial: se mide la dilatación de la arteria braquial mediada por flujo.…”

Section: Fondo De Ojounclassified

Hipertensión arterial en la infancia. Recomendaciones para su diagnóstico y tratamiento. Parte 1. Rama de Nefrología Infantil, Sociedad Chilena de Pediatría

Salas¹,

González

Carrillo

et al. 2019

Rev Chil Pediatr

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La hipertensión arterial (HTA) en niños y adolescentes es una patología importante, asociada a factores modificables y no modificables. En la edad pediátrica, la prevalencia de la HTA es de alrededor de un 3,5%, y va aumentando progresivamente con la edad. El método ideal para su diagnóstico es la medición de la presión arterial (PA) con instrumentos auscultatorios. Según lo publicado por la Academia Americana de Pediatría (AAP) la PA debe ser medida en niños mayores de 3 años una vez al año, y en niños menores de 3 años, si presenta factores de riesgo. Una vez confirmada la HTA, la evaluación debe dirigirse hacia la detección de una enfermedad causal y a la búsqueda de factores de riesgo asociados a una HTA primaria. El objetivo del tratamiento de la HTA primaria y secundaria en pediatría es lograr un nivel de PA que disminuya el riesgo de daño de órgano blanco. Las opciones terapéuticas incluyen: tratamiento según etiología específica, no farmacológico y farmacológico. Este documento es producto de un esfuerzo colaborativo de la Rama de Nefrología de la Sociedad Chilena de Pediatría con el objetivo de ayudar a los pediatras y nefrólogos infantiles en el diagnóstico y tratamiento de la HTA en la infancia. En esta primera parte, se presentan las recomendaciones del diagnóstico y estudio.

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Abnormalities of vascular structure and function in pediatric hypertension

Cited by 37 publications

References 86 publications

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Progression to hypertension in youth and young adults with type 1 or type 2 diabetes: The SEARCH for Diabetes in Youth Study

Hipertensión arterial en la infancia. Recomendaciones para su diagnóstico y tratamiento. Parte 1. Rama de Nefrología Infantil, Sociedad Chilena de Pediatría

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