Chapter 22 - Conceptual Barriers to the Treatment of Chronic Disease: Using Pediatric Hypertension as an Example

Abstract

Chronic disease has become more and more important, as other types of medical problems have been solved or ameliorated; therefore it is now the main type of problem that needs to be addressed and solved. The importance of high blood pressure in relation to cardiovascular morbidity and mortality is well established. High blood pressure control is an especially challenging problem because it clearly has important behavioral elements in addition to its more familiar medical elements. In the conventional view of hypertension in the young, there are at least four myths that have been particularly troublesome and persistent. These myths are particularly germane to the problem of adolescent hypertension. Hypertension is something that begins very early in life, even though the damage from high blood pressure may not show up for many years. As the immediate dangers of hypertension in the young are usually small, the treatment methods employed obviously need to be relatively moderate and risk-free, except in cases of extreme high blood pressure.