Andersons pediatric cardiology 1598
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SystemicHypertension
ManishD.Sinha,ChristopherReid
Abstract
Systemicarterialhypertension,oneofthemostcommoncardiovascular
diseasesinadults,hascontinuedtoincreaseinprevalenceacrossallage
groupsamongchildrenandyoungadults.Theseincreasingnumbersare
primarilysecondarytotheepidemicofchildhoodobesityandoverweight.
Alargebodyofliteratureconfirmsthatbloodpressurelevelsduring
childhood,similartoexcessweightstatus,trackintoadulthoodwith
abnormalbloodpressurelevelsduringchildhoodoftenresultingin
hypertensionasyoungadults.Respondingtothisemergingpublichealth
issue,expertcommitteeshavecalledforscreeningforelevatedblood
pressureinasymptomaticchildren,particularlyashypertensioninchildren
remainspoorlyrecognized.Primaryoressentialhypertensionisthemost
commonformofhypertensioninadults,butitisbecomingincreasingly
clearthattheoriginofthisconditionisinchildhoodandnowaccountsfor
themostcommoncauseofhypertensioninagechildren10yearsandolder.
Secondaryhypertensionisassociatedwithmoreseverehypertension,often
withmoreimmediateclinicalconsequencesandiscommonlycausedby
renaldisease.Earlyrecognitionofhypertensionandjudicioususeof
suitableantihypertensiveagentsenablethebloodpressuretobecontrolled
inallpatients,withminimalundesirablesideeffects.Consequentlythe
managementofhypertensionisparticularlyrewardingforthepracticing
pediatrician.
Keywords
pediatric;measurement;evaluation;tracking;primaryhypertension;
management;antihypertensivemedication
