Čes-slov Pediat 2025, 80(1):39-46 | DOI: 10.55095/CSPediatrie2025/006
Hypertension in children and adolescents
- 1 Klinika dětského lékařství, Fakultní nemocnice Ostrava
- 2 Klinika dětí a dorostu, 3. lékařská fakulta, Univerzita Karlova, Praha
- 3 Pediatrická klinika, 2. lékařská fakulta, Univerzita Karlova, Praha
Arterial hypertension i sone of the most common risk factor for cardiovascular morbidity and mortality in adults and cardiovascular and kidney diseases in children. These recommendations for diagnosis and treatment of hypertension in children are based on the current recommendations of the European Society for Hypertension and the European Academy of Pediatrics.(1,2)
Hypertension in children is defined as repeatedly (at least 3×) blood pressure ≥ 95th percentile. For adolescents aged 16 and over, it
is recommended to use the adult criteria. The incidence of hypertension in childhood has risen significantly in the last decade to an incidence of 1-4%. Hypertension is divided into primary (essential) and secondary. Every child with hypertension must be carefully examined. Basic tests that must be performed in all children with hypertension include urine and blood tests, kidney ultrasound, and
echocardiography.
The treatment of hypertension consists in the treatment of the underlying disease in cases of secondary hypertension (causal), in non-pharmacological measures (reduction of overweight/obesity, reduction of excessive salt intake and sufficient exercise) and pharmacological treatment. Nowadays, five groups of antihypertensive drugs are allowed for children. ACE-inhibitors are the
drug of first choice for renal hypertension. The goal of treatment is not only to normalize BP, but also to induce regression of hypertension-mediated organ damage (left ventricular hypertrophy, albuminuria).
Keywords: blood pressure, hypertension-mediated organ damage, kidneys, left ventricular hypertrophy, albuminuria
Accepted: December 4, 2024; Published: February 1, 2025 Show citation
References
- Lurbe E, Enrico AR, Cruickshank JK, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertension 2016; 34(10): 1887-1920.
Go to original source... 
Go to PubMed... - Wühl E, Calpe J, Drożdż D, et al. Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 2. How to manage high blood pressure in children and adolescents. Front Pediatr 2023; 11: 1140617. Go to original source... Go to PubMed...
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary. Hypertension 2018; 71(6): 1269-1324. doi: 10.1161/HYP.0000000000000066 Go to original source... Go to PubMed...
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. J Hypertens 2018; 36(10): 1953-2041. doi: 10.1097/HJH.0000000000001940 Go to original source... Go to PubMed...
- Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023; 41(12): 1874-2071. Go to original source... Go to PubMed...
- Wühl E, Trivelli A, Picca S, et al. Strict blood-pressure control and progression of renal failure in children. New Engl J Med 2009; 361(17): 1639-1650. doi: 10.1056/NEJMoa0902066 Go to original source... Go to PubMed...
- Seeman T, Gilik J, Vondrak K, et al. Regression of left-ventricular hypertrophy in children and adolescents with hypertension during ramipril monotherapy. Am J Hypertens 2007; 20(9): 990-996. doi: 10.1016/j.amjhyper.2007.03.009 Go to original source... Go to PubMed...
- Assadi F. Effect of microalbuminuria lowering on regression of left ventricular hypertrophy in children and adolescents with essential hypertension. Pediatric Cardiol 2007; 28(1): 27-33. doi: 10.1007/s00246-006-1390-4 Go to original source... Go to PubMed...
- Rocchini AP, Katch V, Anderson J, et al. Blood pressure in obese adolescents: effect of weight loss. Pediatrics 1988; 82(1): 16-23.
- Rajjo T, Almasri J, Al Nofal A, et al. The association of weight loss and cardiometabolic outcomes in obese children: systematic review and meta-regression. 2016; 101(12): 4764-4768. doi: 10.1210/jc.2016-2575 Go to original source...
- Andersen LB, Riddoch C, Kriemler S, Hills A. Physical activity and cardiovascular risk factors in children. Br J Sports Med 2011; 45(11): 871-876. doi: 10.1136/bjsports-2011-090333 Go to original source... Go to PubMed...
- Gutin B. Blood pressure, fitness, and fatness in 5- and 6-year-old children. JAMA 1990; 264(9). doi: 10.1001/jama.1990.03450090059025 Go to original source...
- Hansen HS, Froberg K, Hyldebrandt N, Nielsen JR. A controlled study of eight months of physical training and reduction of blood pressure in children: the Odense schoolchild study. BMJ 1991; 303(6804): 682-685. doi: 10.1136/bmj.303.6804.682 Go to original source... Go to PubMed...
- Seeman T, Dostalek L, Gilik J. Control of hypertension in treated children and its association with target organ damage. Am J Hypertens 2012; 25(3): 389-395. doi: 10.1038/ajh.2011.218 Go to original source... Go to PubMed...
- Seeman T, Gilik J. Long-term control of ambulatory hypertension in children: improving with time but still not achieving new blood pressure goals. Am J Hypertens 2013; 26(7): 939-945. doi: 10.1093/ajh/hpt048 Go to original source... Go to PubMed...
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