Pediatric hypertension

Abstract

Pediatric hypertension (HTN) is a significant and growing health concern. While previously thought to be an uncommon condition in the pediatric population, recent studies have shown an increase in incidence, which is largely due to the obesity epidemic. Accordingly, primary or idiopathic HTN has become more prevalent compared to secondary causes of HTN. The incidence of hypertension is about 3.5%; however, it may be higher as HTN can be missed during routine pediatric well visits. Since childhood HTN frequently tracks into adulthood and is a risk factor for both cardiovascular disease and progression of renal disease; early diagnosis and management of this condition is essential. In this review, we will discuss the approach of a pediatric nephrologist for evaluation and management of pediatric HTN.

The Impact of Paediatric Obesity on Drug Pharmacokinetics: A Virtual Clinical Trials Case Study with Amlodipine

“…The rising trend of obesity among children profoundly impacts the prevalence of hypertension in childhood, and amlodipine as a CCB is recommended as treatment when it is unresponsive to lifestyle modification [ 12 , 23 , 73 , 90 , 91 , 92 , 93 ].…”

Pediatric Hypertension: A Condition That Matters

“…Endocrinologically based secondary hypertension is less frequent in children and accounts for 5-10% of all causes [29]. Therefore, screening for endocrine hypertension in children should occur only following the exclusion of renal and cardiovascular causes [29].…”

“…Endocrinologically based secondary hypertension is less frequent in children and accounts for 5-10% of all causes [29]. Therefore, screening for endocrine hypertension in children should occur only following the exclusion of renal and cardiovascular causes [29]. Hypertension due to endocrinological issues is frequently part of a syndromic pattern, where some other clinical signs such as pubertal delay, growth restriction, obesity, or features suggestive of Cushing's disorder might be recognized.…”

InSH Consensus Guideline for the Management of Hypertension, 2023

“…However, when any risk factors are present-such as prematurity <32 weeks gestation, small for gestational age or low birth weight, history of umbilical artery line, congenital heart disease, recurrent urinary tract infections, or abnormal urinalysis, known renal disease or urologic malformations, family history of renal disease, history of solid-organ transplant, malignancy or bone marrow transplant, treatment with medications known to increase BP, a BMI ≥ 95th percentile 375 , diabetes, aortic arch obstruction or coarctationblood pressure measurements should be taken during every clinic visit, regardless of the child's age. 363,372,376,377…”

“…caused by an underlying disorder or the use of certain medications (Refer to sections 12.0.2 & 12.2) More prone to manifest at a younger age 372,373. …”