Hypertension in Children and Adolescents: Epidemiology and Pathogenesis

Abstract

High blood pressure is one among the leading contributors to burden of disease globally. Approximately 54 % of stroke and 47 % of ischemic heart disease events worldwide were attributable to high blood pressure in the year 2001. There is deficiency of data on the long-term outcome of hypertension in children. In spite of this, there is sufficient evidence to suspect that the health risks of hypertension in pediatric patients are substantial. Hypertension in childhood is known to result in hypertension in young adulthood. The epidemiology of hypertension in children is well represented from various studies conducted across continents. Factors like methodological issues in measurement, socio demographic differences, adiposity levels and ethnicity appear to influence the distribution of blood pressure as well as prevalence of hypertension in children. The etio-pathogenesis of essential (primary) hypertension is multi-factorial in origin. Obesity, insulin resistance, activation of sympathetic nervous system, alterations in sodium homeostasis, renin-angiotensin system changes, changes in vascular smooth muscle structure and reactivity, high serum uric acid levels, genetic factors and fetal programming have been reported to contribute to this disorder. The causes of secondary hypertension vary with age. Renal disorders and coarctation of the aorta are the most common causes of hypertension in children up to age 6 y. In older children, renal parenchymal disease remains the most frequent cause of increased blood pressure. Other causes of hypertension in children are relatively rare and include systemic arteritis and certain tumours, endocrine dysfunction, and neurologic disorders.

Impact of Yogic Intervention on Mild Hypertensive Patients

“…1 Almost 80 million U.S adults are suffering with High blood pressure currently. With less than half of those are having controlled Hypertension, 62% of Cardio vascular diseases and 49% of Ischemic heart disease are caused due to uncontrolled Hypertension.…”

The Prevalence of High Blood Pressure Among Children aged 11-18 Years in Birjand District, Eastern Iran in 2012: A Cross-Sectional Study

“…In India a survey of 24,842 school children in the age group 5 to 16 years where blood pressure data was available for 20,263 students. Hypertension by single measurement was diagnosed in 10.10 % of those with normal weight, 17.34 % in the overweight and 18.32 % in the obese (4). A study from Iran on 21,111 children in the age group of 6 to 18 years showed overall 7.7 % prevalence of systolic and diastolic hypertension (7).…”

“…Moreover, there is evidence that children with mildly elevated blood pressure (BP) are at increased risk for developing adult hypertension (3). Evidence of target organ damage, such as left ventricular hypertrophy (LVH) and pathological vascular changes have been found even in children with a recent diagnosis of high BP (4). Therefore, study on prevalence and early diagnosis of hypertension in childhood is an important strategy for promoting public health and prevention of cardiovascular diseases.…”

Role of autonomic nervous system in the pathomechanism of hypertension

“…It is described as HT, in which there are no secondary causes of increased BP [4]. The essential hypertension is a highly heterogeneous disease and does not have one assigned pathomechanism, however it is considered a result of coexistence of many pathologic factors [5,6].…”