Vidal Enrico, Murer Luisa, Matteucci Maria Chiara
Pediatric Nephrology, Dialysis and Transplantation Unit, Department of Pediatrics, Padua University Hospital, Padua - Italy.
J Nephrol. 2013 Nov-Dec;26(6):986-92. doi: 10.5301/jn.5000244. Epub 2013 Jan 9.
The burden of hypertension has become increasingly prevalent in children. Hypertension that begins in childhood can carry on into adulthood, therefore early detection, accurate diagnosis and effective therapy of high blood pressure may improve long-term outcomes of children and adolescents. As far as pediatric hypertension is concerned, doubts still persist about the right instruments, modalities and standards of reference that should be used in routine practice. Due to the dynamic process of growth and development, many physiological parameters undergo intensive change with age. Therefore, in children, the definition of hypertension can not rely on a single blood pressure level but should be based on age- and height-specific percentiles. In this review, we introduce the nephrologist to the correct definition of high blood pressure in children. Moreover, we specifically address the main characteristics of different modalities for blood pressure measurement in children, focusing on practical aspects. The latest international guidelines and appropriate standards of reference for office, ambulatory and home blood pressure data collection are presented. As clinicians are being faced with a greater number of children with hypertension, they should be aware of these peculiarities.
高血压在儿童中的负担日益普遍。始于儿童期的高血压可能会持续到成年期，因此高血压的早期发现、准确诊断和有效治疗可能会改善儿童和青少年的长期预后。就儿童高血压而言，对于常规实践中应使用的正确仪器、方式和参考标准仍存在疑问。由于生长发育是一个动态过程，许多生理参数会随着年龄的增长而发生剧烈变化。因此，在儿童中，高血压的定义不能仅依赖于单一的血压水平，而应以年龄和身高特定的百分位数为基础。在这篇综述中，我们向肾脏科医生介绍儿童高血压的正确定义。此外，我们特别阐述了儿童血压测量不同方式的主要特点，重点关注实际操作方面。还介绍了办公室、动态和家庭血压数据收集的最新国际指南及适当的参考标准。由于临床医生面对的高血压儿童数量越来越多，他们应该了解这些特殊情况。
