Varying blood pressure in children: a diagnostic quandary interpreting the Fourth Report

Balsara, Sheri; Samuels, Joshua; Samuel, Joyce P.; Bell, Cynthia

doi:10.1016/j.jash.2018.01.003

Cited by 2 publications

(2 citation statements)

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“…Our meta-analysis evaluates the incidence of pediatric and adolescent hypertension from 1994–2018 over 46 studies (n = 187,663) and has demonstrated a stable frequency of 4% (Range: 1–13%) (Table 1 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. Song et al .’s [ 54 ] systematic review over 47 articles (n = 94,675) demonstrated that the prevalence of childhood hypertension has increased from approximately 75% to 79% among children between ages 6 to 19 years from 2000 to 2015.…”

Section: Etiologymentioning

confidence: 99%

“…Song et al .’s [ 54 ] systematic review over 47 articles (n = 94,675) demonstrated that the prevalence of childhood hypertension has increased from approximately 75% to 79% among children between ages 6 to 19 years from 2000 to 2015. This rapid increase is a cause for concern as children and adolescents with hypertension are prone to developing lifelong cardiovascular disease [ 49 , 50 , 51 , 52 , 53 , 54 ].…”

Section: Etiologymentioning

confidence: 99%

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Cardiovascular implications in adolescent and young adult hypertension

Raina¹,

Khooblall²,

Shah³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Hypertension is one of the most prevalent diseases in the United States, affecting an estimated 3.5% of children and adolescents. It can be adversely affect most organ systems but is particularly detrimental to the heart and vascular systems. The repercussions can be gauged through well-established measures of cardiovascular function including left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), carotid intima media thickness (cIMT), and aortic stiffness. Cardiovascular function is also affected by underlying etiologies of hypertension including chronic kidney disease, polycystic kidney disease, coarctation of the aorta, adrenal disorders, renal artery stenosis, obstructive sleep apnea, as well as various drugs and medications (decongestants, stimulants, Non-steroidal Anti-inflammatory Drugs (NSAIDs), and steroids). Methods: An exhaustive literature search was conducted for clinical data regarding pediatric hypertension. Sixty-seven articles were incorporated with data on 189,477 subjects total. The data was then extracted and categorized as relating to hypertension incidence, LVMI, LVH, cIMT, and/or aortic stiffness. Results: The prevalence of pediatric ( 18 years) hypertension extracted from 47 studies from 1994 to 2018 averaged 4%. The LVMI assessed over 7 studies (n = 661) averaged 39.3 g/ in the hypertensive cohort and 30.1 g/ in the control cohort. The cIMT assessed over 7 studies (n = 580) averaged 0.55 mm in the hypertensive cohort and 0.49 mm in the control cohort. Ambulatory arterial stiffness parameters assessed over 5 studies (n = 573) in the normotensive cohort averaged 99.73 mmHg, 69.81 mmHg, 76.85 mmHg, and 46.90 mmHg, for SBP, DBP, MAP, and PP respectively. Ambulatory arterial stiffness parameters assessed over 5 studies (n = 573) in the hypertensive cohort averaged 129.56 mmHg, 73.69 mmHg, 95.08 mmHg, and 56.80 mmHg, for SBP, DBP, MAP, and PP respectively. Conclusions: The significance of pediatric hypertension is emphasized by evidence of early cardiovascular disease as demonstrated by non-invasive measures including cIMT and arterial stiffness parameters, and target organ damage and including LVH and LVMI factors. Thus, early diagnosis and treatment of high blood pressure is paramount for improving long term cardiovascular health and preventing long term morbidity and mortality.

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