scholarly journals Hypertension in children and adolescents

2020 ◽  
Vol 63 (7) ◽  
pp. 404-409
Author(s):  
Young Hwan Song

Hypertension is a major health problem in most developed and developing countries. Worldwide, approximately 1 billion people have hypertension, and 13% of all deaths are closely related to hypertension. Recently, the prevalence of elevated blood pressure (BP) in children and adolescents has increased, probably due to the increased prevalence of overweight and obesity among youths. Increasing evidence suggests that adult hypertension has its antecedents in childhood, as childhood BP predicts adult BP. Additionally, pediatric hypertension may cause premature atherosclerosis and early development of cardiovascular disease. Therefore, the identification and treatment of hypertension in childhood is likely to have an important impact on long-term outcomes of cardiovascular disease. International hypertension guidelines for children and adolescents have recently been significantly revised, especially regarding the diagnosis of hypertension. This review presents the recent guidelines for the diagnosis, evaluation, management, and treatment of hypertension in children and adolescents.

Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract


HIV Medicine ◽  
2021 ◽  
Author(s):  
Allison Silverstein ◽  
William Kamiyango ◽  
Jimmy Villiera ◽  
Erin C. Peckham‐Gregory ◽  
Casey L. McAtee ◽  
...  

Author(s):  
Reshmi Morris ◽  
Ronald Feinstein ◽  
Martin Fisher

Abstract Due to the growth of the epidemic of obesity and the association of obesity with both short-term and long-term medical complications, many professional organizations have recommended performing laboratory testing as part of the initial evaluation of overweight and obese children and adolescents. We report on the results of laboratory testing performed on 110 patients (mean age 14.0 years, range 8–20 years) referred to our weight management program between 2011 and 2013. Our results showed mild abnormalities in levels of cholesterol, glucose, liver enzymes, and thyroid stimulating hormone (TSH) in fewer than 5% of patients for each test and no changes in management based on these results for any of the patients. We call for re-consideration of the recommendations for laboratory testing in children and adolescents being evaluated and treated for overweight and obesity.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Stephen D. Cha ◽  
Hiren P. Patel ◽  
David S. Hains ◽  
John D. Mahan

Hypertension (HTN) is found in about 3-4% of the pediatric population with long-term risks of end organ damage if untreated or poorly controlled. Although children with HTN are being more frequently screened for end organ damage (i.e., LVH), the cognitive effects of HTN and methods to screen for cognitive dysfunction have not been extensively explored. In recent years, there have been a small number of studies that have provided important insights that can guide future research in this area. These studies show that HTN can be associated with headaches, restlessness, sleep disturbance, anxiety, depression, decreased attention, and also poor executive functioning. By increasing the utilization of cognitive tests in hypertensive children and adolescents, important cognitive defects secondary to HTN may be detected. More research is needed in the area, and the results of future studies could have far reaching implications for long-term outcomes in hypertensive children and adolescents.


2009 ◽  
Vol 24 (10) ◽  
pp. 1939-1949 ◽  
Author(s):  
Marc B. Lande ◽  
Joseph T. Flynn

2018 ◽  
Vol 39 (7) ◽  
pp. 1433-1439 ◽  
Author(s):  
Laura Mercer-Rosa ◽  
Xuemei Zhang ◽  
Ronn E. Tanel ◽  
Jack Rychik ◽  
Mark A. Fogel ◽  
...  

2021 ◽  
Vol 50 (4) ◽  
pp. 85-96
Author(s):  
Marijana Jandrić-Kočić

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.


2021 ◽  
Vol 48 (1) ◽  
pp. 42-49
Author(s):  
Hoyeon Kang ◽  
Yongkwon Chae ◽  
Koeun Lee ◽  
Hyo-seol Lee ◽  
Sungchul Choi ◽  
...  

This study aimed to evaluate the long-term outcomes of teeth treated with reattachment technique in children and adolescents. Twenty seven permanent anterior teeth from 21 patients treated with fragment reattachment were evaluated. Clinical photos and medical records were used to assess treatment outcomes. Effect of pulp treatment and the ratio of fragment on success rate were statistically analyzed. Detachment of fragment was observed in 17 teeth, and their duration of retention was 21.41 ± 23.39 months. Repeated trauma was found to be the most frequent causes of failure. Pulp treatment before reattachment did not affect the success rate (<i>p</i> > 0.05). The mean ratio of fragment was 0.482 ± 0.147, and the success rate was affected by the ratio of fragment (<i>p</i> = 0.018). The median retention time of the teeth was 72 months if the ratio was under 0.5, and 8 months for that of the others. A significant correlation was found between the ratio of fragment and retention time (<i>p</i> = 0.003). Reattachment can be a predictable treatment option for crown fracture in anterior teeth in children and adolescents when a fracture involves less than 50% of the clinical crown.


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