Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Cardiology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Can J Cardiol. 2017 May;33(5):577-585. doi: 10.1016/j.cjca.2017.03.007. Epub 2017 Mar 14.
After the 2016 guidelines for blood pressure measurement, diagnosis, and investigation of pediatric hypertension, we now present evidence-based guidelines for the prevention and treatment of hypertension in children. These guidelines were developed by Hypertension Canada's Guideline Committee pediatric subgroup after thorough evaluation of the available literature. Included are 10 guidelines specifically addressing health behaviour management, indications for drug therapy in children with hypertension, choice of therapy for children with primary hypertension, and goals of therapy for children with hypertension. Although the pediatric literature is inherently limited by small numbers of participants, fewer trials, and a prolonged latency to the development of vascular outcomes, this report reflects the current and highest level of evidence and provides guidance for primary care practitioners on the management of pediatric hypertension. Studies of therapeutic lifestyle modifications in children are available to guide current management and more antihypertensive drugs have been studied in children since the Food and Drug Administration Modernization Act. Consistent with Hypertension Canada's guideline policy, diagnostic and therapeutic algorithm tools will be developed and the guidelines will be reviewed annually and updated according to new evidence.
在 2016 年《儿童高血压血压测量、诊断和调查指南》之后,我们现在提出了基于证据的儿童高血压预防和治疗指南。这些指南是由加拿大高血压协会指南委员会儿科小组在对现有文献进行彻底评估后制定的。其中包括 10 条专门针对健康行为管理、儿童高血压药物治疗指征、原发性高血压儿童治疗选择以及高血压儿童治疗目标的指南。尽管儿科文献本身受到参与者人数少、试验少以及血管结局发展潜伏期长的限制,但本报告反映了当前和最高水平的证据,并为初级保健医生提供了儿童高血压管理的指导。目前的管理可以参考儿童治疗性生活方式改变的研究,自《食品和药物管理局现代化法案》以来,更多的降压药物已经在儿童中进行了研究。符合加拿大高血压协会的指南政策,将开发诊断和治疗算法工具,并且每年审查指南,并根据新证据进行更新。