pediatrics
Hypertension in Children
Introduction
Hypertension is sustained elevation of resting systolic blood pressure, diastolic blood pressure, or both; the pressures considered abnormal in children vary based on age up to age 13. Hypertension with no known cause (primary) is most common as with adults. Hypertension with an identified cause (secondary hypertension) is relatively uncommon in children. Usually, children have no symptoms or complications of hypertension during childhood, although these may develop later. Diagnosis is by sphygmomanometry. Tests may be done to look for causes of secondary hypertension. Treatment involves lifestyle changes, drugs, and management of treatable causes. It has become clear over the past few decades that Hypertension is affected by both intrauterine and neonatal conditions and often begins in childhood. Also, sequelae of hypertension in adulthood occur earlier in patients who were hypertensive as children. Thus, it is important to identify and treat hypertension in children. In the US, the prevalence of hypertension in children ranges between 2.2% and 3.9% with high normal readings between 3.4% and 4%. Worldwide, prevalence is less clear because of regional differences in definitions, reference data, and methodology but is estimated at about 4%. In addition, the prevalence appears to be increasing, likely due to the increased incidence of overweight and obesity in children; obesity is now twice as common among adolescents as it was 30 years ago (see Obesity in Adolescents ). Obese adolescents are more likely than their peers to have hypertension. 