Pediatric Blood Pressure and Cardiovascular Health in Adulthood.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Hypertension Reports Pub Date : 2024-11-01 Epub Date: 2024-06-15 DOI:10.1007/s11906-024-01312-5
Yaxing Meng, Jonathan P Mynard, Kylie J Smith, Markus Juonala, Elaine M Urbina, Teemu Niiranen, Stephen R Daniels, Bo Xi, Costan G Magnussen
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Abstract

Purpose of review: This review summarizes current knowledge on blood pressure in children and adolescents (youth), with a focus on primary hypertension-the most common form of elevated blood pressure in this demographic. We examine its etiology, progression, and long-term cardiovascular implications. The review covers definitions and recommendations of blood pressure classifications, recent developments in measurement, epidemiological trends, findings from observational and clinical studies, and prevention and treatment, while identifying gaps in understanding and suggesting future research directions.

Recent findings: Youth hypertension is an escalating global issue, with regional and national variations in prevalence. While the principles of blood pressure measurement have remained largely consistent, challenges in this age group include a scarcity of automated devices that have passed independent validation for accuracy and a generally limited tolerance for ambulatory blood pressure monitoring. A multifaceted interplay of factors contributes to youth hypertension, impacting long-term cardiovascular health. Recent studies, including meta-analysis and sophisticated life-course modelling, reveal an adverse link between youth and life-course blood pressure and subclinical cardiovascular outcomes later in life. New evidence now provides the strongest evidence yet linking youth blood pressure with clinical cardiovascular events in adulthood. Some clinical trials have expanded our understanding of the safety and efficacy of antihypertensive medications in youth, but this remains an area that requires additional attention, particularly regarding varied screening approaches. This review outlines the potential role of preventing and managing blood pressure in youth to reduce future cardiovascular risk. A global perspective is necessary in formulating blood pressure definitions and strategies, considering the specific needs and circumstances in low- and middle-income countries compared to high-income countries.

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小儿血压与成年后的心血管健康
综述目的:本综述总结了当前有关儿童和青少年(青年)血压的知识,重点关注原发性高血压--这一人群中最常见的血压升高形式。我们研究了其病因、进展和对心血管的长期影响。综述内容包括血压分类的定义和建议、测量方法的最新发展、流行病学趋势、观察性研究和临床研究的结果以及预防和治疗,同时找出认识上的差距,并提出未来的研究方向:青少年高血压是一个不断升级的全球性问题,其发病率存在地区和国家差异。虽然血压测量的原则在很大程度上保持一致,但这一年龄组面临的挑战包括通过独立准确性验证的自动设备稀缺,以及对非卧床血压监测的容忍度普遍有限。青少年高血压是多方面因素相互作用的结果,影响着长期的心血管健康。最近的研究,包括荟萃分析和复杂的生命过程模型,揭示了青少年和生命过程血压与日后亚临床心血管后果之间的不利联系。现在,新的证据提供了最有力的证据,证明青少年时期的血压与成年后的临床心血管事件有关。一些临床试验拓展了我们对青少年降压药物安全性和有效性的认识,但这仍然是一个需要更多关注的领域,尤其是在各种筛查方法方面。本综述概述了预防和管理青少年血压对降低未来心血管风险的潜在作用。考虑到中低收入国家与高收入国家相比的特殊需求和情况,在制定血压定义和策略时有必要采用全球视角。
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来源期刊
Current Hypertension Reports
Current Hypertension Reports 医学-外周血管病
CiteScore
10.50
自引率
0.00%
发文量
65
审稿时长
6-12 weeks
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
期刊最新文献
Is There a Role for SGLT2 Inhibitors in Patients with End-Stage Kidney Disease? Advances on the Experimental Research in Resistant Hypertension. Importance of the (Pro)renin Receptor in Activating the Renin-Angiotensin System During Normotensive and Preeclamptic Pregnancies. Hypertension and Cardiovascular Outcomes in Inflammatory and Autoimmune Diseases: A Systematic Review and Meta-analysis. Pediatric Blood Pressure and Cardiovascular Health in Adulthood.
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