Control of Hypertension in Treated Children and Its Association With Target Organ Damage

Seeman, Tomáš; Dostálek, Lukáš; Gilík, Jiří

doi:10.1038/ajh.2011.218

Cited by 39 publications

(26 citation statements)

References 28 publications

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“…In most of the studies included in the systematic review by Kollias et al [15], TOD is related to the absolute BP value (in mmHg). In contrast, other pediatric studies have linked the relative BP level in percentiles with progression of chronic kidney disease [16], and the ambulatory BP index with the development of left ventricular hypertrophy [17]. The link between BP percentiles and TOD validates the use of BP percentiles in children.…”

Section: Bp Levels In Adults and Childrenmentioning

confidence: 84%

Blood pressure (BP) assessment—from BP level to BP variability

Feber

Litwin

2015

Pediatr Nephrol

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The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.

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Section: Bp Levels In Adults and Childrenmentioning

confidence: 84%

Blood pressure (BP) assessment—from BP level to BP variability

Feber

Litwin

2015

Pediatr Nephrol

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“…Nonetheless, there is pediatric evidence that effective antihypertensive treatment induces regression of LVH, ameliorates cardiac geometry and function (22,23,(174)(175)(176). In children with CKD receiving angiotensin converting enzyme inhibitors (ACEi), improved BP control resulted in LVH regression and improved systolic function within 12 months of treatment.…”

Section: Heartmentioning

confidence: 99%

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

Lurbe

Agabiti‐Rosei

Cruickshank

et al. 2016

Journal of Hypertension

994

1,005

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“…This is the approach used with children (summarized in 15 WCH is very common, with a prevalence of 30% to 40% among children with high clinic BP readings. 16,17 WCH is more common among younger children and obese children. It is also more common among children with mildly elevated BP readings, including those with prehypertension.…”

Section: Definition and Diagnosis Of Pediatric Hypertensionmentioning

confidence: 99%

Diagnosis, Epidemiology, and Management of Hypertension in Children

Rao

2016

Pediatrics

131

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National guidelines for the diagnosis and management of hypertension in children have been available for nearly 40 years. Unfortunately, knowledge and recognition of the problem by clinicians remain poor. Prevalence estimates are highly variable because of differing standards, populations, and blood pressure (BP) measurement techniques. Estimates in the United States range from 0.3% to 4.5%. Risk factors for primary hypertension include overweight and obesity, male sex, older age, high sodium intake, and African American or Latino ancestry. Data relating hypertension in childhood to later cardiovascular events is currently lacking. It is known that BP in childhood is highly predictive of BP in adulthood. Compelling data about target organ damage is available, including the association of hypertension with left ventricular hypertrophy, carotid-intima media thickness, and microalbuminuria. Guidelines from both the United States and Europe include detailed recommendations for diagnosis and management. Diagnostic standards are based on clinic readings, ambulatory BP monitoring is useful in confirming diagnosis of hypertension and identifying white-coat hypertension, masked hypertension, and secondary hypertension, as well as monitoring response to therapy. Research priorities include the need for reliable prevalence estimates based on diverse populations and data about the long-term impact of childhood hypertension on cardiovascular morbidity and mortality. Priorities to improve clinical practice include more education among clinicians about diagnosis and management, clinical decision support to aid in diagnosis, and routine use of ambulatory BP monitoring to aid in diagnosis and to monitor response to treatment.

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Control of Hypertension in Treated Children and Its Association With Target Organ Damage

Abstract: This is the first pediatric study, to our knowledge, on BP control in hypertensive children using ABPM. It indicates that control of HT is inadequate in ~50% of treated children. Inadequate control of HT is associated with target organ damage in this population.

Cited by 39 publications

References 28 publications

Blood pressure (BP) assessment—from BP level to BP variability

Blood pressure (BP) assessment—from BP level to BP variability

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents

Diagnosis, Epidemiology, and Management of Hypertension in Children

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