Pediatric hypertension as an early manifestation of cardiovascular disease in children.

Autor: Koch VHK; Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil., Furusawa EA; Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil.
Jazyk: English; Portuguese
Zdroj: Jornal brasileiro de nefrologia [J Bras Nefrol] 2024 May 03; Vol. 46 (4), pp. e20230159. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI: 10.1590/2175-8239-JBN-2023-0159en
Abstrakt: In adults, cardiovascular events associated with arterial hypertension (AH) have a major impact on morbidity and mortality. In light of recent findings, AH in children has been interpreted as early cardiovascular disease (CVD), while exposure to CV risk factors in children proves to be a predictor of subclinical CVD in adults. The American College of Cardiology/American Heart Association has recently updated the classifications for measuring blood pressure (BP) in adults and children. Primary AH in children is generally asymptomatic, and it is associated with a family history of AH, overweight/obesity, and normal morphofunctional characteristics of the urinary system. The younger the child and the higher the BP, the greater the likelihood of secondary AH. The investigation into the etiology of AH begins with a detailed anamnesis, which should include clinical information and details on the use of medication, smoking, and alcohol consumption from the perinatal period to the time of consultation. Modifying risk factors by reducing weight, decreasing alcohol consumption and increasing vegetable intake from childhood to adulthood has been associated with the resolution of AH in the childhood-adulthood transition, and with the reversal of cardiometabolic adverse effects in non-obese adult individuals. Pharmacological therapy should be initiated in cases of symptomatic AH, AH secondary to chronic kidney disease or diabetes mellitus, presence of target organ lesions, stage 2 AH with no modifiable cause and resistant AH unresponsive to lifestyle changes.
Databáze: MEDLINE