All Title Author
Keywords Abstract

Health  2016 

Hypertension in Adolescent

DOI: 10.4236/health.2016.811110, PP. 1065-1074

Keywords: Hypertension, Diagnostic Approach, Prevention, Treatment, Adolescent

Full-Text   Cite this paper   Add to My Lib

Abstract:

Hypertension in adolescents is, as in other patients, one of the important cardiovascular risk factors, associated with hypertension in adults and with appearance of cardiovascular complications later in life. In recent years it is in increase, in parallel with occurrence of overweight in this age group. There is mostly essential or obesity-related hypertension. It is often asymptomatic, therefore it holds true also for adolescents, that it has to be actively searched, especially in risk groups such as overweight adolescents, adolescents with positive family history or some of the other classical cardiovascular risk factors. If we have normal-weight adolescent with important hypertension or symptomatic adolescent without positive family history, the possibility of secondary hypertension has to be thinking of and extended, on possible cause focused and stepwise diagnostics performed. In this case, the treatment is etiological. Otherwise, the first-line treatment in adolescents comprises nonpharmacological treatment measures. Sometimes, because of poor nonpharmacological treatment compliance and presence of hypertensive-target organ damage, antihypertensive medications have to be introduced. However, preventive actions represent the most important task, in the form of primary and primordial prevention. In this article, diagnostic approach, prevention and treatment strategies in adolescents are shortly presented.

References

[1]  May, A.L., Kuklina, E.V. and Yoon, P.W. (2012) Prevalence of Cardiovascular Disease Risk Factors among US Adolescents, 1999-2008. Pediatrics, 129, 1035-1041.
http://dx.doi.org/10.1542/peds.2011-1082
[2]  Flynn, J. (2012) The Changing Face of Pediatric Hypertension in the Era of the Childhood Obesity Epidemic. Pediatric Nephrology, 28, 1059-1066.
http://dx.doi.org/10.1007/s00467-012-2344-0
[3]  Moore, W.E., Stephens, A., Wilson, T., Wilson, W. and Eichner, J.E. (2006) Body Mass Index and Blood Pressure Screening in a Rural Public School System: the Healthy Kids Project. Preventing Chronic Disease, 3, 1-10.
http://www.cdc.gov/pcd/issues/2006/oct/05_0236.htm
[4]  Falkner, B., Gidding, S.S., Portman, R. and Rosner, B. (2008) Blood Pressure Variability and Classification of Prehypertension and Hypertension in Adolescence. Pediatrics, 122, 238-242.
http://dx.doi.org/10.1542/peds.2007-2776
[5]  Marcun Varda, N. (2006) The Role of Some Genetic Factors in the Development of Essential Hypertension in Children and Young Adults. Ph.D. Dissertation, Med-ical Faculty Ljubljana, Ljubljana.
[6]  Sorof, J.M., Lai, D., Turner, J., Poffenburger, T. and Portman, R.J. (2004) Overweight, Ethnicity, and the Prevalence of Hypertenison in School-Aged Children. Pediatrics, 113, 475-482.
http://dx.doi.org/10.1542/peds.113.3.475
[7]  Chen, X. and Wang, Y. (2008) Tracking of Blood Pressure from Child-hood to Adulthood: A Systematic Review and Meta-Regression Analysis. Circulation, 117, 3171-3180.
http://dx.doi.org/10.1161/CIRCULATIONAHA.107.730366
[8]  Lawes, C.M., Vander Hoorn, S., Law, M.R., Elliott, P., MacMahon, S. and Rodgers, A. (2006) Blood Pressure and the Global Burden of Disease 2000. Part II: Estimates of Attributable Burden. Journal of Hypertension, 24, 423-430.
http://dx.doi.org/10.1097/01.hjh.0000209973.67746.f0
[9]  Franks, P.W., Hanson, R.L., Knowler, W.C., Sievers, M.L., Bennett, P.H. and Looker, H.C. (2010) Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death. New England Journal of Medicine, 362, 485-493.
http://dx.doi.org/10.1056/NEJMoa0904130
[10]  Sundstrom, J., Neovius, M., Tynelius, P. and Rasmussen, F. (2011) Association of Blood Pressure in Late Adolescence with Subsequent Mortality: Cohort Study of Swedish Male Conscripts. British Medical Journal, 342, d643.
http://dx.doi.org/10.1136/bmj.d643
[11]  National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics, 144, 555-576.
[12]  Lurbe, E., Cifkova, R., Cruickshank Kennedy, J., Dillon, M.J., Ferreira, I., Invitti, C., et al. (2009) Management of High Blood Pressure in Children and Adolescents: Recommendations of the European Society of Hypertension. Journal of Hypertension, 27, 1719-1742.
http://dx.doi.org/10.1097/HJH.0b013e32832f4f6b
[13]  Varda, N.M. and Gregoric, A. (2005) A Diagnostic Approach for the Child with Hypertension. Pediatric Nephrology, 20, 499-506.
http://dx.doi.org/10.1007/s00467-004-1737-0
[14]  Woroniecki, R.P. and Flynn, J.T. (2005) How Are Hypertensive Children Evaluated and Managed? A Survey of North American Pediatric Nephrologists. Pediatric Nephrology, 20, 791-797.
http://dx.doi.org/10.1007/s00467-004-1804-6
[15]  Capwell, S. and Lloyd-Jones, D.M. (2010) Optimal Cardiovascular Prevention Strategies for the 21st Century. JAMA, 304, 2057-2058.
http://dx.doi.org/10.1001/jama.2010.1641
[16]  Kones, R. (2011) Primary Prevention of Coronary Heart Disease: Integration of New Data, Evolving Views, Revised Goals, and Role of Rosuvastatin in Management. A Comprehensive Survey. Drug Design, Development and Therapy, 5, 325-380.
http://dx.doi.org/10.2147/DDDT.S14934
[17]  Dabl Educational Trust (2016) Blood Pressure Monitors—Validations, Papers and Reviews.
http://www.dableducational.org/
[18]  Neu-hauser, H.K., Thamm, M., Ellert, U., Hense, H.W. and Rosario, A.S. (2011) Blood Pressure Percentiles by Age and Height from Nonoverweight Children and Adolescents in Germany. Pediatrics, 127, e978-e988.
http://dx.doi.org/10.1542/peds.2010-1290
[19]  Kulaga, Z., Litwin, M., Grajda, A., Kulaga, K., Gurzkowska, B., Gózdz, M., et al. and OLAF Study Group (2012) Oscillometric Blood Pressure Percentiles for Polish Normal-Weight School-Aged Children and Adolescents. Journal of Hypertension, 30, 1942-1954.
http://dx.doi.org/10.1097/HJH.0b013e328356abad
[20]  Mancia, G., Fagard, R., Narkiewicz, K., Redán, J., Zanchetti, A., Bohm, M., et al. (2013) 2013 Practice Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. Journal of Hypertension, 31, 1925-1938.
http://dx.doi.org/10.1097/HJH.0b013e328364ca4c
[21]  Symonides, B., Jedrusik, P., Artyszuk, L., Grybos, A., Dziliński, P. and Gaciong, Z. (2010) Different Diagnostic Criteria Significantly Affect the Rates of Hypertension in 18-Year-Old High School Students. Archives of Medical Science, 6, 689-694.
http://dx.doi.org/10.5114/aoms.2010.17082
[22]  Simckes, A.M., Srivastava, T. and Alon, U.S. (2002) Ambulatory Blood Pressure Monitoring in Children and Adolescents. Clinical Pediatrics, 41, 549-564.
http://dx.doi.org/10.1177/000992280204100801
[23]  Soergl, M., Kirschstein, M., Busch, C., Danne, T., Gellermann, J., Holl, R., et al. (1997) Oscillometric Twenty-Four-Hour Ambulatory Blood Pressure Values in Healthy Children and Adolescents: A Multicenter Trial Including 1141 Subjects. Journal of Pediatrics, 130, 178-184.
http://dx.doi.org/10.1016/S0022-3476(97)70340-8
[24]  Metoki, H., Ohkubo, T., Kikuya, M., Asayama, K., Obara, T., Hara, A., et al. (2006) Prognostic Significance of Night-Time, Early Morning, and Daytime Blood Pressures on the Risk of Cerebrovascular and Cardiovascular Mortality: The Ohasama Study. Journal of Hypertension, 24, 1841-1848.
http://dx.doi.org/10.1097/01.hjh.0000242409.65783.fb
[25]  Belsha, C.W. (1999) Ambulatory Blood Pressure Monitor-ing and Hypertensive Target-Organ Damage in Children. Blood Pressure Monitoring, 4, 161-164.
[26]  Marcun Varda, N. (2012) Diagnostic Evaluation of the Child and Adolescent with Hypertension. Slovenska Pediatrija, 19, 276-285.
[27]  Litwin, M., Niemirska, A., Sladowska-Kozlowska, J., Wierzbicka, A., Janas, R., Wawer, Z.T., et al. (2010) Regression of Target Organ Damage in Children and Adolescents with Primary Hypertension. Pediatric Nephrology, 25, 2489- 2499.
http://dx.doi.org/10.1007/s00467-010-1626-7
[28]  Sladowska-Kozlowska, J., Litwin, M., Niemirska, A., Wierzbicka, A., Wawer, Z.T. and Janas, R. (2011) Change in Left Ventricular Geometry during Antihypertensive Treatment in Children with Primary Hypertension. Pediatric Nephrology, 26, 2201-2209.
http://dx.doi.org/10.1007/s00467-011-1916-8
[29]  Assadi, F. (2007) Effect of Microalbuminuria Lowering on Regression of Left Ventricular Hypertrophy in Children and Adolescents with Essential Hypertension. Pediatric Cardiology, 28, 27-33.
http://dx.doi.org/10.1007/s00246-006-1390-4
[30]  Lande, M.B., Carson, N.L., Roy, J. and Meagher, C.C. (2006) Effects of Childhood Primary Hypertension on Carotid Intima Media Thickness: A Matched Controlled Study.Hypertension, 48, 40-44.
http://dx.doi.org/10.1161/01.HYP.0000227029.10536.e8
[31]  Litwin, M., Trelewicz, J., Wawer, Z., Antoniewicz, J., Wierzbicka, A., Rajszys, P., et al. (2004) Intima-Media Thickness and Arterial Elasticity in Hypertensive Children: Controlled Study. Pediatric Nephrology, 19, 767-774.
http://dx.doi.org/10.1007/s00467-004-1480-6
[32]  Urbina, E.M., Williams, R.V., Alpert, B.S., Collins, R.T., Daniels, S.R., Hayman, L., et al. (2009) Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement from the American Heart Association. Hypertension, 54, 919-950.
http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.192639
[33]  Lloyd-Jones, D.M., Hong, Y., Labarthe, D., Mozaffarian, D., Appel, L.J., Van Horn, L., et al. (2010) American Heart Association Strategic Planning Task Force and Statistics Committee. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association’s Strategic Impact Goal through 2020 and beyond. Circulation, 121, 586-613.
http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192703
[34]  Hong, Y.M. (2010) Atherosclerotic Cardiovascular Disease Beginning in Childhood. Korean Circulation Journal, 40, 1-9.
http://dx.doi.org/10.4070/kcj.2010.40.1.1
[35]  Falkner, B., Lurbe, E. and Schaefer, F. (2010) High Blood Pressure in Children: Clinical and Health Policy Implications. Journal of Clinical Hypertension, 12, 261-276.
http://dx.doi.org/10.1111/j.1751-7176.2009.00245.x
[36]  Kavey, R.E.W., Daniels, S.R. and Flynn, J.T. (2010) Management of High Blood Pressure in Children and Adolescents. Cardiology Clinics, 28, 597-607.
http://dx.doi.org/10.1016/j.ccl.2010.07.004
[37]  Kavey, R.E.W., Simons-Morton, D. and Jesus, J.M. (2011) Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report. Pediatrics, 128, S213-S256.
http://dx.doi.org/10.1542/peds.2009-2107C
[38]  Lande, M.B. and Flynn, J.T. (2009) Treatment of Hypertension in Children and Adolescents. Pediatric Nephrology, 24, 1939-1949.
http://dx.doi.org/10.1007/s00467-007-0573-4
[39]  Flynn, J.T. and Tullus, K. (2009) Severe Hypertension in Children and Adolescents: Pathophysiology and Treatment. Pediatric Nephrology, 24, 1101-1112.
http://dx.doi.org/10.1007/s00467-008-1000-1
[40]  Varon, J. (2008) Treatment of Acute Severe Hypertension. Drugs, 68, 283-297.
http://dx.doi.org/10.2165/00003495-200868030-00003
[41]  Roberts, C.K. and Barnard, R.J. (2005) Effects of Exercise and Diet on Chronic Disease. Journal of Applied Physiology, 98, 3-30.
http://dx.doi.org/10.1152/japplphysiol.00852.2004
[42]  Williams, C.L., Hayman, L.L., Daniels, S.R., Robinson, T.N., Steinberger, J., Paridon, S., et al. (2002) Cardiovascular Health in Childhood. A Statement for Health Professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young. American Heart Association, Circulation, 106, 143-160.
http://dx.doi.org/10.1161/01.cir.0000019555.61092.9e
[43]  Couch, S.C., Saelens, B.E., Levin, L., Dart, K., Falciglia, G. and Daniels, S.R. (2008) The Efficacy of a Clinic-Based Behavioral Nutrition Intervention Emphasizing a DASH-Type Diet for Adolescents with Elevated Blood Pressure. Journal of Pediatrics, 152, 494-501.
http://dx.doi.org/10.1016/j.jpeds.2007.09.022
[44]  He, F.J. and MacGregor, G.A. (2006) Importance of Salt in Determining Blood Pressure in Children: Meta-Analysis of Controlled Trials. Hypertension, 48, 861-869.
http://dx.doi.org/10.1161/01.HYP.0000245672.27270.4a
[45]  Kelley, G.A., Kelley, K.S. and Tran, Z.V. (2003) The Effects of Exercise on Resting Blood Pressure in Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials. Preventive Cardiology, 6, 8-16.
http://dx.doi.org/10.1111/j.1520-037X.2003.01224.x
[46]  Rocchini, A.P., Katch, V., Anderson, J., Hinderliter, J., Becque, D., Martin, M. and Marks, C. (1988) Blood Pressure in Obese Adolescents: Effect of Weight Loss. Pediatrics, 82, 16-23.
[47]  Flynn, J.T. (2009) Hypertension in the Young: Epidemiology, Sequelae and Therapy. Nephrology Dialysis Transplantation, 24, 370-375.
http://dx.doi.org/10.1093/ndt/gfn597
[48]  Kupferman, J.C., Paterno, K., Mahgerefteh, J., Pagala, M., Golden, M., Lytrivi, I.D., et al. (2010) Improvement of Left Ventricular Mass with Antihy-pertensive Therapy in Children with Hypertension. Pediatric Nephrology, 25, 1513-1518.
http://dx.doi.org/10.1007/s00467-010-1511-4
[49]  Flynn, J.T. (2011) Not Ready for Prime Time: Aliskiren for Treatment of Hypertension or Proteinuria in Children. Pediatric Nephrology, 26, 491-492.
http://dx.doi.org/10.1007/s00467-010-1726-4
[50]  Herder, S.D., Weber, E., Winkemann, A., Herder, E. and Morck, H. (2010) Efficacy and Safety of Angiotensin II Receptor Type 1 Antagonists in Children and Adolescents. Pediatric Nephrology, 25, 801-811.
http://dx.doi.org/10.1007/s00467-009-1346-z
[51]  Li, J.S., Flynn, J.T., Portman, R., Davis, I., Ogawa, M., Shi, H., Pressler, M.L., et al. (2010) The Efficacy and Safety of the Novel Aldosterone Antagonist Eplerenone in Children with Hypertension: A Randomized, Double-Blind, Dose-Response Study. Journal of Pediatrics, 157, 282-287.
http://dx.doi.org/10.1016/j.jpeds.2010.02.042
[52]  Schaefer, F., Litwin, M., Zachwieja, J., Zurowska, A., Turi, S., Grosso, A., et al. (2011) Efficacy and Safety of Valsartan Compared to Enalapril in Hypertensive Children. A 12-Week, Randomized, Double-Blind, Parallel-Group Study. Journal of Hypertension, 29, 2484-2490.
http://dx.doi.org/10.1097/HJH.0b013e32834c625c
[53]  Chaturvedi, S., Lipszyc, D.H., Licht, C., Craig, J.C. and Parekh, R.S. (2014) Cochrane in Context: Pharmacological Interventions for Hypertension in Children. Evidence Based Child Health, 9, 581-583.
http://dx.doi.org/10.1002/ebch.1975
[54]  Flynn, J.T., Meyers, K.E., Neto, J.P., de Paula, M.R., Zurowska, A., Bagga, A., et al. (2008) Efficacy and Safety of the Angiotensin Receptor Blocker Valsartan in Children with Hypertension Aged 1 to 5 Years. Hypertension, 52, 222-228.
http://dx.doi.org/10.1161/HYPERTENSIONAHA.108.111054
[55]  Schaefer, F., van de Walle, J., Zurowska, A., Gimpel, C., van Hoeck, K., Drozdz, D., et al. and Candesartan in Children with Hypertension Investigators (2010) Efficacy, Safety and Pharmacokinetics of Candesartan Cilexetil in Hypertensive Children from 1 to Less than 6 Years of Age. Journal of Hypertension, 28, 1083-1090.
http://dx.doi.org/10.1097/HJH.0b013e328336b86b
[56]  Flynn, J.T. (2011) Management of Hypertension in the Young: Role of Antihypertensive Medications. Journal of Cardiovascular Pharmacology, 58, 111-120.
http://dx.doi.org/10.1097/FJC.0b013e31820d1b89
[57]  Marcun Varda, N. and Gregoric, A. (2011) Hypertensive Target Organ Damage and Antihypertensive Treatment in Children with Essential Hypertension. Pediatric Nephrology, 26, 1726.
[58]  Santi, M., Simonetti, B.G., Leoni-Foglia, C.F., Bianchetti, M.G. and Simonetti, G.D. (2015) Arterial Hypertension in Children. Current Opinion in Cardiology, 30, 403-410.
http://dx.doi.org/10.1097/HCO.0000000000000191
[59]  Osterberg, L. and Blaschke, T. (2005) Adherence to Medication. New England Journal of Medicine, 353, 487-497.
http://dx.doi.org/10.1056/NEJMra050100
[60]  Eakin, M.N., Brady, T., Kandasamy, V., Fivush, B. and Riekert, K.A. (2013) Disparities in Antihypertensive Medication Adherence in Adolescents. Pediatric Nephrology, 28, 1267-1273.
http://dx.doi.org/10.1007/s00467-013-2455-2
[61]  Rao, G. (2016) Diagnosis, Epidemiology, and Management of Hypertension in Children. Pediatrics, 138, e20153616.
http://dx.doi.org/10.1542/peds.2015-3616

Full-Text

comments powered by Disqus