Cochrane in context: Pharmacological interventions for hypertension in children

Chaturvedi, Swasti; Lipszyc, Deborah; Licht, Christoph; Craig, Jonathan C.; Parekh, Rulan S.

doi:10.1002/ebch.1975

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…There are precarious data on the long-term sequelae of persistent hypertension in children, but it is known that there is evidence of target organs and risk hypertension in adulthood. In most cases, nonpharmacological measures are recommended as first-rate therapy, but a significant proportion of children will need pharmacological treatment to control SAH, especially those with evidence of target organs, but also for those who fail Lifestyle modifications, which have chronic kidney disease and/or diabetes mellitus with hypertension, symptomatic hypertension and stage 2 hypertension at presentation or during followup (Chaturvedi;et. Al, 2014).…”

Section: Resultsmentioning

confidence: 99%

Secondary hypertension in the pediatric group: a review

Hammes¹,

Diogo²,

Cavalli³

et al. 2023

Development and Its Applications in Scientific Knowledge

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Secondary systemic arterial hypertension (SAH) is a potentially curable disease. The pediatric population is the most affected. Due to the lack of deep investigation for secondary causes by health care professionals, many children end up living with the pathology without being diagnosed. Since SAH is a disease that evolves with lesions in several organs, treatment is expected to be carried out early, avoiding chronic health damage. The present research aimed to analyze the underdiagnosis of secondary SAH in children and its repercussion; describe the definition of secondary SAH; identify the main causes of secondary hypertension, and analyze forms of diagnosis and treatment. An integrative bibliographic review of secondary hypertension was carried out in children and adolescents between 2013 to 2022. Twenty-seven studies were chosen for this research. Studies have shown a significant degree of underrecognition of high blood pressure (BP) and hypertension, which is related to the steps needed to determine BP percentiles and the lack of SAH screening in pediatric consultations, which must be done through regular manual measurement of the blood pressure. All children with SAH should be investigated for secondary causes. If the diagnosis is confirmed, treatment of the underlying disease should be done by a specialist. Underdiagnosis of secondary hypertension is still very common since screening is not routinely performed in this age group. Therefore, strategies to improve the acceptance of guidelines should be prioritized.

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Section: Resultsmentioning

confidence: 99%

Secondary hypertension in the pediatric group: a review

Hammes¹,

Diogo²,

Cavalli³

et al. 2023

Development and Its Applications in Scientific Knowledge

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“…The most common comorbidities in the study population were dyslipidemia, diabetes mellitus, cardiovascular diseases, and obesity, which is supported by the findings of the study by Alkaabi et al (2019) [ 15 ]. As per the literature, insulin resistance and obesity play a central role in causing HTN and dyslipidemia [ 16 ]. Very few Indian studies have been published on the correlation between screen time exposure and HTN.…”

Section: Discussionmentioning

confidence: 99%

Indian Clinician’s Perspective on the Approach to the Management of Hypertension: A Cross-Sectional Study

Ram,

Muruganathan,

et al. 2024

Cureus

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Introduction Hypertension (HTN) is considered one of the most frequent life-threatening noncommunicable illnesses. Because HTN has a significant public health impact on cardiovascular health status and healthcare systems in India, it is critical to study Indian clinicians' approaches to HTN management. Methodology This was a cross-sectional, multicentric, non-interventional, and single-visit study that aimed to gather data from across India and examine sociodemographic characteristics and clinician treatment choices in the management of HTN in Indian individuals. As a result, building an information platform about HTN is critical to preventing and controlling this growing burden. Results A total of 5298 patients were recruited in the study from 1061 study centers across India. Among the study patients, 66.67% were females with a mean age of 53.95 ± 14.4, and 66.28% of hypertensive patients presented comorbidities. Among the known risk factors for HTN, 2227 (44.5%) were smokers, while 2587 (51.7%) had sedentary lifestyles. A family history of HTN in either one or both parents was seen in 1076 (21.50%) patients. In management, 40.40% of patients were on anti-hypertensive monotherapy. Amlodipine (41.8%) in monotherapy and amlodipine + metoprolol (32.34%) in combination therapy were the most commonly prescribed antihypertensive. Conclusion Management of HTN can be improved by imparting patient education and awareness about the need for medication compliance, lifestyle modifications, and regular follow-up clinic visits.

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“…A Cochrane review found 21 randomized controlled trials, usually of short duration and without placebo control groups. Most studies showed BP lowering effects of antihypertensive drugs without severe adverse effects (Grade B) ( 28 ). However, no pediatric randomized controlled trials have investigated the efficacy of any antihypertensive drug on the prevention or regression of HMOD.…”

Section: Treatmentmentioning

confidence: 99%

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 2. How to manage high blood pressure in children and adolescents

Wühl

Calpe²,

Drożdż

et al. 2023

Front. Pediatr.

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The joint statement is a synergistic action between HyperChildNET and the European Academy of Pediatrics about the diagnosis and management of hypertension in youth, based on the European Society of Hypertension Guidelines published in 2016 with the aim to improve its implementation. Arterial hypertension is not only the most important risk factor for cardiovascular morbidity and mortality, but also the most important modifiable risk factor. Early hypertension-mediated organ damage may already occur in childhood. The duration of existing hypertension plays an important role in risk assessment, and structural and functional organ changes may still be reversible or postponed with timely treatment. Therefore, appropriate therapy should be initiated in children as soon as the diagnosis of arterial hypertension has been confirmed and the risk factors for hypertension-mediated organ damage have been thoroughly evaluated. Lifestyle measures should be recommended in all hypertensive children and adolescents, including a healthy diet, regular exercise, and weight loss, if appropriate. If lifestyle changes in patients with primary hypertension do not result in normalization of blood pressure within six to twelve months or if secondary or symptomatic hypertension or hypertension-mediated organ damage is already present, pharmacologic therapy is required. Regular follow-up to assess blood pressure control and hypertension-mediated organ damage and to evaluate adherence and side effects of pharmacologic treatment is required. Timely multidisciplinary evaluation is recommended after the first suspicion of hypertension. A grading system of the clinical evidence is included.

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Cochrane in context: Pharmacological interventions for hypertension in children

Cited by 6 publications

References 2 publications

Secondary hypertension in the pediatric group: a review

Secondary hypertension in the pediatric group: a review

Indian Clinician’s Perspective on the Approach to the Management of Hypertension: A Cross-Sectional Study

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 2. How to manage high blood pressure in children and adolescents

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