Primary hypertension and special aspects of hypertension in older children and adolescents

Ellis, Demetrius; Miyashita, Yosuke

doi:10.2147/ahmt.s11715

Cited by 13 publications

(11 citation statements)

References 135 publications

(174 reference statements)

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“…However, hypertension in obese children may need a different diagnostic and treatment approach from that for children with secondary hypertension. Obesity-related hypertension, often referred to as primary hypertension, is often less severe and less symptomatic in comparison to secondary hypertension [10]; thus, for example, a consultation with an ophthalmologist to check for hypertensive retinopathy might not be necessary. In addition, a lifestyle intervention might suffice as treatment for hypertension in obesity, whereas secondary hypertension most likely requires pharmacological treatment [11].…”

Section: Introductionmentioning

confidence: 99%

Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

et al. 2016

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Hypertension in obese children may require a different diagnostic and treatment approach from that for children with secondary hypertension, yet there is neither consensus nor a clear guideline. The aim of this study was to assess how obese children with hypertension are currently diagnosed and treated by paediatric nephrologists, what obstacles exist and what can be improved. In the period May–November 2014, an online questionnaire was sent to all members of the European Society for Paediatric Nephrology (n = 2148). Questions focused on current practices and obstacles regarding screening, diagnosis and treatment of hypertension in obese children. A total of 214 paediatric nephrologists responded. Although nearly 100 % agreed that screening of obese children for hypertension is indicated, it was current practice in only 56 % of participating countries; 88 % of respondents diagnosed hypertension with 24-h ambulatory blood pressure measurement. Diagnostics used to rule out causes or consequences of hypertension varied among the respondents; they included, in particular, the use of serum renin/aldosterone, urine sodium/potassium, and dimercaptosuccinic acid scan. Concerning treatment, 45 % of respondents preferred to start treatment with a lifestyle program, 2 % with antihypertensive medication, and 40 % with both. For 73 % of respondents, angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers were the drugs of first choice. The findings of this study emphasize the urgent need for an international guideline for screening, diagnosis and treatment of hypertension in obese children.Electronic supplementary materialThe online version of this article (doi:10.1007/s40620-016-0277-6) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

et al. 2016

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“…Outcome refers to what actually happens, such as the mortality rate in myocardial infarctions. This approach suggests organizations should evaluate the care they deliver on an on-going basis, thus making small changes to improve their individual processes over time [6,31].…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…Unfortunately, this is increasingly becoming a problem for children (3-11 years of age) and adolescents (12-17 years of age). From 1993 to 2004, the prevalence of hypertension in the pediatric population increased from 1.0% to 4.5% [6]. This increase in prevalence is due to the increasing rate of childhood obesity, and heightened awareness of pediatric hypertension among health care providers [7].…”

Section: Introductionmentioning

confidence: 99%

Synergy of Technology and Healthcare: The Development of a Smartphone Application to Detect Hypertension in Children and Adolescents

Bussenius¹,

Wold²,

Williams³

2013

Transl Med

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The prevalence of hypertension and pre-hypertension in the pediatric population is increasing. The development of primary hypertension earlier in life increases the chances of cardiovascular morbidity and mortality later in life. Studies have shown that 34 to 38% of children and adolescents with mild untreated hypertension already show signs of left ventricular hypertrophy. Evidence shows that childhood and adolescent hypertension and pre-hypertension are under-recognized due to a number of factors including lack of provider knowledge regarding the National High Blood Pressure Educational Program (NHBPEP) guidelines for diagnosing, evaluation, and treatment of high blood pressure in children and adolescents. Another issue is the complexity of diagnosing HTN in this population that requires utilizing 1,904 variables based on gender, age, and height percentile delineated from the CDC development charts. To more easily detect hypertension in children and adolescents, a Smartphone application, Pedia BP, was designed and developed. The existing tables from The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP, 2005), which contain hundreds of normal and abnormal blood pressure values based on gender, age, and height percentile, were analyzed and streamlined into a much simplified, single user interface Smartphone application. Pedia BP makes it easy to identify abnormal blood pressure values in an accurate and timely manner and resides on the mobile device so Internet access is not required and can be used in any setting. The time saving Pedia BP application, allows the practitioner to quickly follow best practice protocols regarding management of identified issues.

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“…[1] Therefore, susceptibility of this cohort of population to metabolic disorders was somewhat overlooked. [2,3] Nowadays, it is widely recognised that even in youth the hypertension (HT) [4] and the type two diabetes (T2DM) can be contracted. [5] Moreover, the current epidemiological research supports the understanding that obesity in adolescence, but not necessarily in childhood, is tracking into adulthood; and the same is true of markers indicating risk of the cardiovascular disease (CVD) and T2DM.…”

Section: Introductionmentioning

confidence: 99%

“…[15] These thresholds are sometimes interpreted as cut-off levels triggering indication for treatment by one or other means. [15] While there is a strong correlation of high BMI with various cardiometabolic disorders such as CVD, HT, and most notably T2DM, [2,4,5] and increased mortality from these and other causes, [17] these numbers are nothing more but a selected by consensus the origin (25 kg/m 2 ) and the unit of measure (5 kg/m 2 ) for the excessiveness of human body weight. Historically, the 5 kg/m 2 is approximately the standard deviation (SD) of BMI distribution in a large population, and 25 kg/m 2 is approximately the mean plus SD, so that within one SD of the mean BMI is regarded normal or healthy.…”

Section: Introductionmentioning

confidence: 99%

Correspondence between waist-to-height ratio and body mass index in juniors

Yatsko

2017

JBEI

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Despite the increase in body mass through childhood and adolescence is countered by the increase in height in the Body Mass Index (BMI), this measure is inadequate for judging the degree of excess weight among the young. Unlike using clearly defined cut points, same for any stage of adulthood, it is required to consult BMI-for-age charts, which can be a demanding exercise when data analysis is involved. The waist circumference to height ratio (WCHR) was hypothesised to be invariant to age change, and this is generally supported by the epidemiological evidence. This paper analyses a sample of NHANES data to find a connection between BMI, WCHR and Age. A strong linearity between the anthropometric measures is demonstrated, thus enabling estimation of WCHR for a given BMI and Age. The pattern of change of this parameter at BMI levels that indicate the transition to overweight state or obesity thus becomes unravelled. The results strongly support the feasibility of a universal WCHR threshold for the overweight state past early childhood and through adolescence, and the estimated one is similar to the WCHR levels found elsewhere in the literature.

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Primary hypertension and special aspects of hypertension in older children and adolescents

Cited by 13 publications

References 135 publications

Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

Synergy of Technology and Healthcare: The Development of a Smartphone Application to Detect Hypertension in Children and Adolescents

Correspondence between waist-to-height ratio and body mass index in juniors

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