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Avesani M, Calcaterra G, Sabatino J, Pelaia G, Cattapan I, Barillà F, Martino F, Pedrinelli R, Bassareo PP, Di Salvo G. Pediatric Hypertension: A Condition That Matters. CHILDREN (BASEL, SWITZERLAND) 2024; 11:518. [PMID: 38790513 PMCID: PMC11120267 DOI: 10.3390/children11050518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Systemic hypertension has been considered mainly as an adult health issue for a long time, but it is now being increasingly acknowledged as a significant problem also among pediatric patients. The frequency of pediatric hypertension has grown mostly because of increases in childhood obesity and sedentary lifestyles, but secondary forms of hypertension play a role as well. Considering that unaddressed hypertension during childhood can result in enduring cardiovascular complications, timely identification and intervention are essential. Strategies for addressing this disease encompass not only lifestyle adjustments, but also the use of medications when needed. Lifestyle modifications entail encouraging a nutritious diet, consistent physical activity, and the maintenance of a healthy weight. Moreover, educating both children and their caregivers about monitoring blood pressure at home can aid in long-term management. Thus, the aim of this review is to discuss the etiologies, classification, and principles of the treatment of hypertension in pediatric patients.
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Affiliation(s)
- Martina Avesani
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
| | | | - Jolanda Sabatino
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (J.S.); (G.P.)
| | - Giulia Pelaia
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (J.S.); (G.P.)
| | - Irene Cattapan
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
| | - Francesco Barillà
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Francesco Martino
- Department of Internal Medicine, Anaesthesiology, and Cardiovascular Sciences, Sapienza University, 00185 Rome, Italy;
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Pier Paolo Bassareo
- School of Medicine, University College of Dublin, Mater Misericordiae University Hospital, D07 KH4C Dublin, Ireland;
| | - Giovanni Di Salvo
- Division of Pediatric Cardiology, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy; (M.A.); (I.C.)
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Gaffar S, Ramanathan R, Easterlin MC. Common Clinical Scenarios of Systemic Hypertension in the NICU. Neoreviews 2024; 25:e36-e49. [PMID: 38161177 DOI: 10.1542/neo.25-1-e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Hypertension affects ∼1% to 3% of newborns in the NICU. However, the identification and management of hypertension can be challenging because of the lack of data-driven diagnostic criteria and management guidelines. In this review, we summarize the most recent approaches to diagnosis, evaluation, and treatment of hypertension in neonates and infants. We also identify common clinical conditions in neonates in whom hypertension occurs, such as renal vascular and parenchymal disease, bronchopulmonary dysplasia, and cardiac conditions, and address specific considerations for the evaluation and treatment of hypertension in those conditions. Finally, we discuss the importance of ongoing monitoring and long-term follow-up of infants diagnosed with hypertension.
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Affiliation(s)
- Sheema Gaffar
- Division of Neonatology, Department of Pediatrics, Los Angeles General Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Rangasamy Ramanathan
- Division of Neonatology, Department of Pediatrics, Los Angeles General Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Molly Crimmins Easterlin
- Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Giammattei VC, Weaver DJ, South AM. Management of acute severe hypertension in youth: from the philosophical to the practical. Curr Opin Pediatr 2023; 35:251-258. [PMID: 36437756 PMCID: PMC9992153 DOI: 10.1097/mop.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Acute severe hypertension remains an uncommon but important source of morbidity and mortality in youth. However, there has been very little progress made in our understanding of how to best manage youth with acute severe hypertension to improve patient outcomes. RECENT FINDINGS Our understanding of what is acute severe hypertension is undergoing a philosophical change. Management of patients with acute severe hypertension is evolving towards more of a risk and outcomes-based approach. SUMMARY We should be intentional when we consider whether a patient has acute severe hypertension and if they are truly at an increased risk for life-threatening target organ injury. We should consider their specific risk factors to best interpret the risks and benefits of how best to treat a patient with acute severe hypertension, rather than relying on traditional approaches and conventional wisdom. We should always ask 'why' when we are pursuing a given management course. Future studies should clearly define the research questions they are investigating to best advance the field to ultimately improve patient outcomes.
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Affiliation(s)
| | - Donald J. Weaver
- Division of Nephrology and Hypertension, Department of Pediatrics, Atrium Health Levine Children's, Charlotte, NC, USA
| | - Andrew M. South
- Section of Nephrology, Department of Pediatrics, Brenner Children’s, Wake Forest University School of Medicine, Winston Salem, NC, USA
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC, USA
- Cardiovascular Sciences Center, Wake Forest University School of Medicine, Winston Salem, NC, USA
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Cho MH. Hypertension in adulthood is programmed during the perinatal period. Clin Exp Pediatr 2022; 65:494-495. [PMID: 35996798 PMCID: PMC9561185 DOI: 10.3345/cep.2022.00829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Min Hyun Cho
- Department of Pediatrics, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
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