Recent Clinical and Translational Advances in Pediatric Hypertension

Falkner, Bonita

doi:10.1161/hypertensionaha.114.03586

Cited by 52 publications

(54 citation statements)

References 55 publications

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“…48 As expected, systolic and diastolic BP reduced significantly after reducing salt intake and there was a greater chance of HTN in children with higher sodium diets (odds ratio=2). 48,49 In CKD, this reduction in BP was accompanied by a reduction in proteinuria. 50 As such, reduced salt diets are recommended in children with HTN and CKD.…”

Section: Salt Intake Htn and Ckdmentioning

confidence: 99%

Hypertension in pediatric patients with chronic kidney disease: management challenges

Gallibois¹,

Jawa²,

Noone³

2017

IJNRD

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Abstract:In contrast to adults where hypertension is a leading cause of chronic kidney disease, in pediatrics, hypertension is predominantly a sequela, however, an important one that, like in adults, is likely associated with a more rapid decline in kidney function or progression of chronic kidney disease to end stage. There is a significant issue with unrecognized, or masked, hypertension in childhood chronic kidney disease. Recent evidence and, therefore, guidelines now suggest targeting a blood pressure of <50th percentile for age, sex, and height in children with proteinuria and chronic kidney disease. This often cannot be achieved by monotherapy and additional agents need to be added. Blockade of the renin angiotensin aldosterone system represents the mainstay of therapy, although often limited by the side effect of hyperkalemia. The addition of a diuretic, at least in the earlier stages of chronic kidney disease, might help mitigate this problem.

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Section: Salt Intake Htn and Ckdmentioning

confidence: 99%

Hypertension in pediatric patients with chronic kidney disease: management challenges

Gallibois¹,

Jawa²,

Noone³

2017

IJNRD

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“…In adult populations, the definition of hypertension is based on the relation between BP and subsequent development of CVD, renal or other related events. However, since it is difficult to assess events related to elevated BP in children and adolescents because of generally long time lag between exposure and outcomes, 9 elevated BP in children and adolescents is usually defined based on the distribution of BP in a reference population. It is generally considered that children and adolescents have elevated BP if their BP values are in the upper range of the distribution (e.g., hypertension if BP above the 95th percentile).…”

Section: Introductionmentioning

confidence: 99%

Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years

et al. 2016

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Background Several distributions of country-specific blood pressure (BP) percentiles by sex, age and height for children and adolescents have been established worldwide. However, there are no globally unified BP references for defining elevated BP in children and adolescents, which limit international comparisons of prevalence of pediatric elevated BP. We aimed to establish international BP references for children and adolescents using seven nationally representative data (China, India, Iran, Korea, Poland, Tunisia and USA). Methods and Results Data on BP for 52,636 non-overweight children and adolescents aged 6–19 years were obtained from seven large nationally representative cross-sectional surveys in China, India, Iran, Korea, Poland, Tunisia, and USA. BP values were obtained with certified mercury sphygmomanometers in all seven countries, using standard procedures for BP measurement. Smoothed BP percentiles (50th, 90th, 95th and 99th) by age and height were estimated using the Generalized Additive Model for Location Scale and Shape (GAMLSS) model. BP values were similar between males and females until the age of 13 years and were higher in males than females thereafter. Compared to BP level of the 90th and 95th percentiles of the U.S. Fourth Report at median height, systolic BP of the corresponding percentiles of these international references was lower while diastolic BP was similar. Conclusions These international BP references will be a useful tool for international comparison of the prevalence of elevated BP in children and adolescents and may help identify hypertensive youths in diverse populations.

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“…T he available data concerning childhood blood pressure (BP) have increased substantially over the last four decades [1][2][3][4][5][6][7]. Clinicians can use the available pediatric reference BP data to determine whether BP is in the normal range or is at a level that warrants evaluation or preventive intervention.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure in children and adolescents

Lurbe

Ingelfinger

2016

Journal of Hypertension

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The available data concerning childhood blood pressure (BP) have increased substantially over the last four decades. Clinicians can use the available pediatric reference BP data to determine whether BP is in the normal range or is at a level that warrants evaluation or preventive intervention. It has also become possible to refine BP-derived parameters and to identify subclinical end organ damage through measures and markers now far more sensitive than those available years ago. The progress to date should provide an impetus for research advances that may translate into clinical practice. Findings that are becoming ready to incorporate into clinical use include data showing the importance of detecting prehypertension or high-normal BP, the meaning of BP obtained out of the clinic setting and the importance of central BP determinations. Furthermore, new information about large and small vessels during the early stages of BP elevation, the clustering of metabolic abnormalities with BP and the relevance of perinatal programming may lead to better strategies for reducing the impact of BP elevation on cardiovascular health.

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Recent Clinical and Translational Advances in Pediatric Hypertension

Cited by 52 publications

References 55 publications

Hypertension in pediatric patients with chronic kidney disease: management challenges

Hypertension in pediatric patients with chronic kidney disease: management challenges

Establishing International Blood Pressure References Among Nonoverweight Children and Adolescents Aged 6 to 17 Years

Blood pressure in children and adolescents

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