Pediatric Nephrology, University Children's Hospital, Inselspital and University of Bern, 3010, Bern, Switzerland.
Curr Hypertens Rep. 2013 Oct;15(5):444-52. doi: 10.1007/s11906-013-0378-8.
There is growing concern about elevated blood pressure in children and adolescents, because of its association with the obesity epidemic. Moreover, cardiovascular function and blood pressure level are determined in childhood and track into adulthood. Primary hypertension in childhood is defined by persistent blood pressure values ≥ the 95th percentile and without a secondary cause. Preventable risk factors for elevated blood pressure in childhood are overweight, dietary habits, salt intake, sedentary lifestyle, poor sleep quality and passive smoking, whereas non-preventable risk factors include race, gender, genetic background, low birth weight, prematurity, and socioeconomic inequalities. Several different pathways are implicated in the development of primary hypertension, including obesity, insulin resistance, activation of the sympathetic nervous system, alterations in sodium homeostasis, renin-angiotensin system and altered vascular function. Prevention of adult cardiovascular disease should begin in childhood by regularly screening for high blood pressure, counseling for healthy lifestyle and avoiding preventable risk factors.
人们越来越关注儿童和青少年的高血压问题，因为高血压与肥胖症的流行有关。此外，心血管功能和血压水平在儿童时期就已确定，并会一直持续到成年。儿童原发性高血压的定义是血压值持续高于第 95 百分位且没有继发原因。儿童期高血压的可预防危险因素包括超重、饮食习惯、盐摄入量、久坐不动的生活方式、睡眠质量差和被动吸烟，而不可预防的危险因素包括种族、性别、遗传背景、低出生体重、早产和社会经济不平等。原发性高血压的发展涉及多种不同的途径，包括肥胖、胰岛素抵抗、交感神经系统的激活、钠稳态的改变、肾素-血管紧张素系统和血管功能的改变。通过定期筛查高血压、提供健康生活方式的咨询以及避免可预防的危险因素，应该从儿童时期开始预防成年期心血管疾病。
