Hypertension in children

Hypertension is rare in children, and usually associated with underlying renal, endocrine or cardiac pathology. However the prevalence of essential hypertension is rising in older children in association with a worldwide increase in obesity. Pediatric hypertension is known to track into adulthood and is thereby associated with long term cardiovascular morbidities. In addition it can cause acute complications like left ventricular failure and hypertensive encephalopathy and chronic progressive vascular damage in several organ systems.

Children at risk of hypertension require regular monitoring of blood pressure using appropriate equipment and correct cuff sizes. Hypertensive children should be investigated thoroughly for an underlying etiology. Patients should also be screened for evidence of end organ damage. Measurements of arterial stiffness are in a stage of investigation and not yet available for routine clinical use. Management includes family education, institution of lifestyle changes primarily aimed at weight reduction and pharmacotherapy.