Development of Hypertension in Adolescents with Pre-Hypertension

Redwine, Karen M.; Acosta, Alisa A.; Poffenbarger, Timothy; Portman, Ronald J.; Samuels, Joshua

doi:10.1016/j.jpeds.2011.07.010

Cited by 108 publications

(63 citation statements)

References 13 publications

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“…In a general population of adolescents, 10-19 years, the rate of progression from normotension to HTN was 0.4/100 subjects/year, and among those who had high-normal BP it was 1.1/100 subjects/year (42). In another study on normotensive children with a mean follow-up of 35 months, the incidence of sustained HTN was 0.6/100 subjects/year (43).…”

Section: Incidencementioning

confidence: 93%

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

1,042

1,063

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Section: Incidencementioning

confidence: 93%

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

1,042

1,063

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“…6,7 Rather than having a goal of classifying children as high-normal, we should be identifying those who may be at risk for the development of hypertension in the future, in the hopes that lifestyle interventions might be instituted to prevent this development. [8][9][10] …”

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confidence: 99%

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

et al. 2012

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Abstract-The objective was to analyze pulse wave velocity (PWV) in normotensive, high-normal, and hypertensive youths by using aortic-derived parameters from peripheral recordings. The impact of obesity on vascular phenotypes was also analyzed. A total of 501 whites from 8 to 18 years of age were included. The subjects were divided according to BP criteria: 424 (85%) were normotensive, 56 (11%) high-normal, and 21 (4%) hypertensive. Obesity was present in 284 (56%) and overweight in 138 (28%). Pulse wave analysis using a SphygmoCor device was performed to determine central blood pressure (BP), augmentation index, and measurement of PWV. Among the BP groups, differences appeared in age, sex, and height but not in body mass index. Significant differences in peripheral and central systolic and diastolic BPs and pulse pressures were observed within groups. A graded increase in PWV was present across the BP strata without differences in augmentation index. Using a multiple regression analysis, age, BP groups, and obesity status were independently associated with PWV. Older and hypertensive subjects had the highest PWV, whereas, from normal weight status to obesity, PWV decreased. Likewise, PWV was positively related to peripheral or central systolic BP and negatively related to body mass index z score. For 1 SD of peripheral systolic BP, PWV increased 0.329 m/s, and for 1 SD of body mass index z score PWV decreased 0.129 m/s. In conclusion, PWV is increased in hypertensive and even in high-normal children and adolescents. Furthermore, obesity, the factor most frequently related to essential hypertension in adolescents, blunted the expected increment in PWV of hypertensive and high-normal subjects. (Hypertension. 2012;60:550-555.)Key Words: hypertension Ⅲ obesity Ⅲ children Ⅲ adolescents Ⅲ augmentation index Ⅲ pulse wave velocity C ardiovascular damage occurring in adults finds its roots in risk factors operating early in life. Among the factors influencing cardiovascular risk, blood pressure (BP) values represent an important measurable marker of the level of potential cardiovascular risk in children and adolescents. The need to identify cardiovascular risk factors, including high BP, in youth, is acknowledged more and more frequently. Consequently, measurement of BP has become a routine part of pediatric care, and asymptomatic hypertension is now detected in pediatric care practice.BP phenotype is determined not only by conventional risk factors but also by weight gain in childhood. The adverse effects of excessive weight gain on BP and the association of weight gain with higher incidence of BP elevation represent major issues in health care.1-5 Elevation of systolic and/or diastolic BP indicates high BP in the child. In addition, children and adolescents with mild BP elevation, in the high-normal range, are much more common than was thought in the past, ranging from 3.4% to 15.7%. 6,7 Rather than having a goal of classifying children as high-normal, we should be identifying those who may be at risk for the developm...

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“…1,6 Redwine et al showed that having high-normal BP is a higher risk of developing hypertension. 2,3 Additionally, the Fourth Report provides criteria for staging the severity of hypertension in children and adolescents in stage 1 hypertension and stage 2 hypertension, which can be used clinically to guide evaluation and management. 1,3,6 Children with stage 2 hypertension should be evaluated and treated more quickly and/or intensively than those with a lower degree of BP elevation (Table 1).…”

Section: Definition and Classification Of Hypertensionmentioning

confidence: 99%

“…1 Recent reports indicate that hypertension now affects between 3 and 5% of the pediatric population. 2 This makes hypertension one of the most common chronic diseases of childhood, especially in adolescence. 3 Longitudinal studies have made it clear that BP abnormalities during childhood do translate into adult hypertension.…”

Section: Introduction and Purposementioning

confidence: 99%

“…3 Longitudinal studies have made it clear that BP abnormalities during childhood do translate into adult hypertension. [1][2][3][4][5][6] Where there was in the past a predominance of secondary hypertension in children, associated with renal disorders and/or drug therapy, there is now an increasing frequency of essential hypertension. There are two major reference frames for the management of hypertension in children: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents from the National Heart, Lung and Blood Institute 6 and the revised guidelines of the European Society of Hypertension.…”

Section: Introduction and Purposementioning

confidence: 99%

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Management of hypertension in children and adolescents

Bruyne¹,

Walle

2014

Acta Clinica Belgica

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Hypertension has been recognized as an important health issue in the pediatric population over the past years. This emphasizes the need for an organized and effective plan for diagnosis and management. This review provides information to guide physicians through a structured approach to (1) screen children for hypertension during routine visits; (2) use normative blood pressure tables for diagnosis and classification; (3) perform a clinical evaluation to identify the presence of risk factors, comorbidities and/or target organ damage; and (4) initiate an individualized plan of care that includes follow-up blood pressure measurement, therapeutic lifestyle changes and -if necessary -pharmacological therapies.

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Development of Hypertension in Adolescents with Pre-Hypertension

Cited by 108 publications

References 13 publications

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

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

Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth

Management of hypertension in children and adolescents

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