Guidelines for the Management of Hypertension

Zalecenia Sekcji Pediatrycznej Polskiego Towarzystwa Nadciśnienia Tętniczego dotyczące postępowania diagnostycznego i terapeutycznego w nadciśnieniu tętniczym u dzieci i młodzieży

“…Scintigraphy is not recommended in AAP guidelines or in clinical guidelines for adult patients, including the guidelines of the Polish Society of Hypertensions, in the diagnostic algorithm for renovascular hypertension in adults [4,24]. However, in our opinion the assessment of split renal function and analysis of perfusion curves helps in deciding on surgical treatment in difficult cases (young children in whom percutaneous treatment is impossible), allows the evaluation of the treatment effects after interventional procedures (percutaneous treatment/surgery) and is an additional criterion for the diagnosis of hypertensive nephropathy in a kidney with normal renal artery and exposed to high blood pressure before treatment [71].…”

“…These guidelines are an extended and actualized version of paediatric guidelines of the Polish Society of Hypertension published in 2015 and presented in the extended version as Recommendations of the Children's Memorial Health Institute in 2016 [4]. This version of paediatric recommendations of the Polish Society of Hypertension was developed on the basis of the previously published recommendations of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (The 4 th Report), the paediatric recommendations of the European Society of Hypertension (ESH) published in 2009 and 2016, the recommendations of the Children's Memorial Health Institute (2016), the recommendations of the European Society of Cardiology (ESC)/American Heart Association (AHA) (2017), the recommendations of the American Academy of Pediatrics (AAP) (2017), literature review and expert opinions [5][6][7][8].…”

Management of atrial fibrillation in specific patient populations

“…At the same time, in the European document there is a class IIa recommendation for using ARBs and ACEI in patients with arterial hypertension for prevention of new-onset AF, especially in patients with left ventricular hypertrophy, and American guidelines recommend a similar algorithm [11]. Also, the guidelines of the Polish Society of Arterial Hypertension recommend using ACEis, ARB, or (in concomitant heart failure [HF]) eplerenone for prevention of de novo or recurrence of AF [18].…”

“…Oral anticoagulation treatment in hypertensive AF patients with no other risk factors is mandatory according to the European, Canadian, and Polish guidelines, while the American guidelines allow also aspirin or no treatment [3,10,18]. The 'hypertension' criterion in the CHA 2 DS 2 -VASc score refers to history of hypertension or uncontrolled blood pressure.…”

“…2). In hypertensive patients, the most appropriate drugs reducing heart rate in AF include beta-blockers and non-dihydropyridine calcium antagonists (Table 1) [1,11,18]. Table 1.…”