scholarly journals Hypertension in Children and Adolescents: A Position Statement From a Panel of Multidisciplinary Experts Coordinated by the French Society of Hypertension

2021 ◽  
Vol 9 ◽  
Author(s):  
Béatrice Bouhanick ◽  
Philippe Sosner ◽  
Karine Brochard ◽  
Claire Mounier-Véhier ◽  
Geneviève Plu-Bureau ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
Care Pathway ◽  
Paediatric Population ◽  
Position Statement ◽  
French Society ◽  
Cardiovascular Morbidity And Mortality ◽  
And Gender ◽  
Definition Of ◽  
Hypertension In Children

Hypertension is much less common in children than in adults. The group of experts decided to perform a review of the literature to draw up a position statement that could be used in everyday practice. The group rated recommendations using the GRADE approach. All children over the age of 3 years should have their blood pressure measured annually. Due to the lack of data on cardiovascular morbidity and mortality associated with blood pressure values, the definition of hypertension in children is a statistical value based on the normal distribution of blood pressure in the paediatric population, and children and adolescents are considered as having hypertension when their blood pressure is greater than or equal to the 95th percentile. Nevertheless, it is recommended to use normative blood pressure tables developed according to age, height and gender, to define hypertension. Measuring blood pressure in children can be technically challenging and several measurement methods are listed here. Regardless of the age of the child, it is recommended to carefully check for a secondary cause of hypertension as in 2/3 of cases it has a renal or cardiac origin. The care pathway and principles of the therapeutic strategy are described here.

Using height-corrected definition of metabolic syndrome in children and adolescents

2019 ◽  
Vol 32 (5) ◽  
pp. 429-438
Author(s):  
Chunming Ma ◽  
Qiang Lu ◽  
Rui Wang ◽  
Fuzai Yin
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Children And Adolescents ◽  
Age And Gender ◽  
Anthropometric Indexes ◽  
And Gender ◽  
Definition Of ◽  
Hypertension In Children ◽  
Gender Specific

Abstract Metabolic syndrome (MS) is common among children and adolescents. Age- and gender-specific references or age-, gender- and height-specific references were used in pediatric MS definitions. More recently, an increasing number of studies documented that the ratio of waist circumference (WC) to height (WHtR) and blood pressure to height (BPHR) were easy anthropometric indexes for detection of obesity and hypertension in children and adolescents. For these reasons, height-corrected MS definition was proposed. WHtR and BPHR were used as alternatives to WC and BP in the definition of MS. In the present review, we discuss the possibility of the height-corrected MS definition for identifying MS in children.

Secondary Hypertension in Children and Adolescents: Novel Insights

2020 ◽  
Vol 16 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Katerina Chrysaidou ◽  
Athanasia Chainoglou ◽  
Vasiliki Karava ◽  
John Dotis ◽  
Nikoleta Printza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Secondary Hypertension ◽  
Pressure Monitoring ◽  
Cardiovascular Morbidity And Mortality ◽  
Rising Incidence ◽  
Hypertension In Children

Hypertension is a significant risk factor for cardiovascular morbidity and mortality, not only in adults, but in youths also, as it is associated with long-term negative health effects. The predominant type of hypertension in children is the secondary hypertension, with the chronic kidney disease being the most common cause, however, nowadays, there is a rising incidence of primary hypertension due to the rising incidence of obesity in children. Although office blood pressure has guided patient management for many years, ambulatory blood pressure monitoring provides useful information, facilitates the diagnosis and management of hypertension in children and adolescents, by monitoring treatment and evaluation for secondary causes or specific phenotypes of hypertension. In the field of secondary hypertension, there are numerous studies, which have reported a strong association between different determinants of 24-hour blood pressure profile and the underlying cause. In addition, in children with secondary hypertension, ambulatory blood pressure monitoring parameters offer the unique advantage to identify pediatric low- and high-risk children for target organ damage. Novel insights in the pathogenesis of hypertension, including the role of perinatal factors or new cardiovascular biomarkers, such as fibroblast growth factor 23, need to be further evaluated in the near future.

scholarly journals Assessment of the influence of overweight and obesity on the development of prehypertension and hypertension in children aged 6-15

2021 ◽  
Vol 50 (4) ◽  
pp. 85-96
Author(s):  
Marijana Jandrić-Kočić
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Primary School ◽  
Children And Adolescents ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Primary School Children ◽  
Cross Sectional ◽  
Significant Difference ◽  
Hypertension In Children

Introduction/Aim: 41 million children under the age of 5 and 340 million children and adolescents aged 5 to 19 are overweight or obese. Obesity in children and adolescents is the most important predictor of high blood pressure. The aim of the study was to examine the incidence of overweight and obesity in primary school children aged 6 to 15 years, as well as to examine the incidence of prehypertension and hypertension in children who were overweight and obese. Method: The study included 85 of 86 children from the Primary School "Krupa na Uni". Data were collected with the help of a questionnaire, while body weight and blood pressure were measured. The chi-square test and t-test were used for the statistical analysis of data Results: The cross-sectional study included 85 children, 45 (52.9%) boys and 40 (47.1%) girls with an average age of 10.87 ± 2.70 years. Normal weight was found in 54 (63.5%) subjects, underweight in 12 (14.1%), overweight in 5 (5.9%), and obesity in 14 (16.5%). 76 (89.4%) subjects had normal blood pressure values, 5 (5.9%) prehypertensive state, and 4 (4.7%) arterial hypertension. There was no significant difference between younger and older children regarding their nutritional status (p=0.477) and blood pressure levels (p=0.453). Children who were overweight and obese had prehypertension and hypertension significantly more often (p˂0.001). Conclusion: Every fifth child was overweight or obese, while prehypertension or hypertension were found in every tenth child. The timely change of diet and physical activity could contribute to the regulation of body weight and the regulation of blood pressure, as well.

scholarly journals Diagnostics and treatment of arterial hypertension in children and adolescents, overview of new clinical guidelines of the American Academy of Pediatrics

2019 ◽  
Vol 64 (4) ◽  
pp. 114-127 ◽  
Author(s):  
L. I. Agapitov ◽  
I. V. Cherepnina
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Children And Adolescents ◽  
Clinical Guidelines ◽  
Blood Pressure Monitoring ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
New Guidelines ◽  
Hypertension In Children

The article analyzes clinical guidelines oftheAmericanAcademy ofPediatrics dd 2017 “ClinicalPractice Guideline forScreening andManagement of High Blood Pressure in Children and Adolescents”. This document contains new values of blood pressure in children, replaces the term “prehypertension” with the term “elevated blood pressure”, provides a simplified classification of arterial hypertension in adolescents over 13 years and revisesthe guidelinesfor daily blood pressure monitoring and echocardiography. The documentspecifiesthe criteria for diagnosing increased body weight of the left ventricular myocardium, changesthe target blood pressure levels. This new guidelines helps to optimize the diagnostics and treatment of hypertension in children. At the same time there is need for further comprehensive analysis of clinicalrecommendations and assessment of their practicalsignificance for pediatrics.

Incidence of intradialytic hypertension in hemodialysis patients in Beheira governorate and effect of high flux versus low flux dialysis on it

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Gamal E Mady ◽  
Hisham Atef Abou El Leil ◽  
Ahmed M Tawfik ◽  
Ahmed M Elgendy
Keyword(s):  
Blood Pressure ◽  
Serum Creatinine ◽  
High Flux ◽  
Dialysis Patients ◽  
Serum Ipth ◽  
Cardiovascular Morbidity And Mortality ◽  
Significant Difference ◽  
Group 2 ◽  
Definition Of ◽  
Group 1

Abstract Background Intradialytic hypertension (IDH) is a common complication of hemodialysis (HD) that is under-recognized and its significance is underappreciated. No standard definition of IDH exists. As a unifying criteria for the diagnosis of IDH has not been proposed, the focus of this review will be on systolic blood pressure (SBP) rise = 10 mmHg at = 4 over six consecutive sessions. IDH is estimated at 5–15% of HD patients. IDH has been associated with poor clinical outcomes in HD patients including increased hospitalizations, higher ambulatory blood pressure (BP), cardiovascular morbidity, and mortality. Aim of the Work To detect the incidence of IDH in HD patients in Beheira governorate and to compare the effect of high flux versus low flux dialysis on it. Patients and Methods This study was conducted on 200 patients on maintenance HD from different HD units in Beheira governorate. The patients were divided into two groups: Group 1: 100 patients on HD with high flux dialyzers and Group 2: 100 patients on HD with low flux dialyzers. Results: Incidence of IDH in HD patients in Beheira governorate was 23.5% at the start, 21% after one month and 13% after three months duration. Results of our study demonstrated that there were no significant differences between both groups as regards effect of high-flux vs low-flux dialysis on IDH after one month and at the end of the study (P > 0.05), but there was a significant decrease in number of IDH patients after one month duration and after three months in both high-flux and low-flux dialysis patients. In our study, there was significant improvement in the form of reductions in all of pre-dialysis BUN, post-dialysis BUN, serum creatinine levels and serum IPTH levels at the end of the study in high flux group compared to low flux group. Finally, our results showed significant improvement in serum hemoglobin levels in high flux group by the end of the study in contrast to the low flux group. Conclusion No significant difference in the effect of high flux versus low flux dialysis on IDH, but there was significant improvement in all of pre-dialysis BUN, post-dialysis BUN, serum creatinine levels and serum IPTH levels by the end of the study in the high flux group compared to the low flux group.

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