Hypertension in pediatric patients

Abstract

An increasing number of healthy children and adolescents across the world are being diagnosed with hypertension, which is an emerging problem that no pediatrician can afford to ignore. The evidence from developed countries indicates a recent increase in the prevalence of hypertension in children and young adults. In a school-based study in the United States that involved 5102 children with a mean age 13.5 years, the prevalence of hypertension was 4.5%(1). Primary hypertension, once considered a rare occurrence in pediatric patients, is seen more often particularly in obese patients. Other factors that are responsible for increased prevalence of hypertension in children include life style changes such as physical inactivity, increased intake of high-calorie, high-sodium and low-potassium foods, use of caffeinated and alcohol beverages, smoking, mental stress and sleep deprivation(2). Recent scientific advances have enhanced our understanding of the pathophysiological mechanisms involved in hypertension. Recognition of monogenic genetic disorders such as Liddle’s syndrome, glucocorticoid-remediable aldosteronism, and syndrome of apparent mineralocorticoid excess, have made it possible to diagnose and treat effectively a group of patients who in the past would have been diagnosed as having ‘essential hypertension.” Advances in diagnostic tools and the availability of a variety of newer antihypertensive medications, many of which have undergone successful clinical trials in pediatric patients, have made it easier to diagnose and treat hypertension in children.