Problematic issues of pathogenesis, diagnosis, prevention and approaches to the treatment of arterial hypotension in children (literary data, own researches)

Abstract

Arterial hypotension (AHT) is an actual problem in pediatrics. It is a symptom complex characterized by a decrease in systemic blood pressure (BP) and accompanied by a number of clinical symptoms that reflect a decrease in blood flow and perfusion pressure in all organs and tissues. Purpose - to summarize data from the literature and own experience regarding diagnosis, pathogenetic and clinical features of the course and principles of treatment of AHT in children. Results. A review of modern literary data showed a wide range of etiopathogenetic mechanisms of AHT formation and a high specific weight of primary AHT in the pediatric population. A modern method of accurate diagnosis of AHT is daily blood pressure monitoring (DBPM). According to the results of DBPM conducted by us in 677 children aged 8-17 years with complaints of BP fluctuations, AHT was established in 107 (15.8%) examined. AHT in girls occurred almost twice as often compared to boys - 66.4% versus 33.6% (p<0.0001). In 64.5% of cases there was labile AHT, in 33% - stable AHT of the first stage, in 2.5% of children - stable AHT of the II stage. There were no gender differences in the frequency of different degrees of AHT. Conclusions. The issue of low BP is an urgent problem in pediatrics. According to the results of DBPM, AHT is detected in 15.8% of children aged 8-17 years and has a mostly labile course. AHT requires in-depth study in order to develop new preventive and therapeutic measures and to alleviate the consequences in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.