Severe hypertension in childhood.

Lifestyle factors are determinants of children's blood pressure levels: the CYKIDS study

“…52,53 Even hypertension that is less severe contributes to target-organ damage when it occurs with other chronic conditions, such as chronic kidney disease. [54][55][56] Two autopsy studies, 57,58 that evaluated tissue from adolescents and young adults who had sudden deaths due to trauma, demonstrated significant relationships between the level of BP, or hypertension, and the presence of atherosclerotic lesions in the aorta and coronary arteries.…”

Synopsis of the Report of the Second Task Force on Blood Pressure Control in Children.

“…Despite these drawbacks, the benefits of pharmacological therapy in the child with severe hypertension have been established clinically, 46 and therapy should not be withheld in any patient with hypertension of sufficient degree to risk organ damage. The report contains the following indications for initiation of antihypertensive drugs and therapeutic goals:…”

Reflux nephropathy and hypertension

“…This may have contributed to the vast differences in the reported incidences of reflux nephropathy and its associated complications. The data may have been further contaminated by reno-vascular hypertension in children and adolescents that can also be associated with reflux nephropathy 24,48 and by the finding of reflux nephropathy in some adults previously thought to have primary hypertension. 49 In addition, methodological flaws in various studies as highlighted by Shanon and Feldman 50 may have contributed to differences in the reported incidence of hypertension in reflux nephropathy.…”

“…1,[18][19][20] Hypertension affects at least 10% of children with renal scars, [21][22][23] and is the commonest cause of severe hypertension in childhood. [24][25][26][27] In adults with reflux nephropathy the prevalence of hypertension is much higher (38-50%) 5,28,29 reflecting the continued risk of developing hypertension at any age. Jacobson et al (1989) found that hypertension in some adults with renal scarring did not occur until 27 years of follow-up.…”