Center for Child and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Acta Paediatr. 2019 Jan;108(1):37-43. doi: 10.1111/apa.14551. Epub 2018 Sep 19.
The prevalence of childhood hypertension is rising in parallel with global increases in the prevalence of overweight and obesity. We looked at key papers and documents covering three decades.
This mini review examined a wide range of material published in English, with the main focus on 1993-2018, including clinical trials, meta-analyses, guidelines and data produced by the World Health Organization and the World Obesity Federation.
The literature showed that body weight and blood pressure are closely correlated and obesity-related hypertension contributes further to the clustering of cardiovascular risk factors in obesity. Because the duration of hypertension affects the risk of end-organ damage, timely diagnosis and initiation of treatment are important. First-line interventions should aim for blood pressure control and weight reduction. However, lifestyle modifications are often not successful with regard to attaining and maintaining long-term blood pressure and weight control, despite a multidisciplinary approach. Antihypertensive treatment is recommended for all hypertensive children with failure of nonpharmacological treatment, diabetes, secondary hypertension, stage 2 hypertension or target organ damage.
We found that obesity-related hypertension was associated with a significantly increased cardiovascular morbidity and mortality, and early diagnosis and treatment for blood pressure control and weight reduction is essential.
儿童高血压的患病率与超重和肥胖患病率在全球范围内的上升呈平行关系。我们查阅了涵盖三十年的关键文献和文件。
本迷你综述研究了广泛的英文文献，主要聚焦于 1993 年至 2018 年的研究，包括临床试验、荟萃分析、指南以及世界卫生组织和世界肥胖联合会的数据。
文献表明，体重和血压密切相关，肥胖相关的高血压会进一步导致肥胖中心血管危险因素的聚集。由于高血压的持续时间会影响终末器官损伤的风险，因此及时诊断和开始治疗非常重要。一线干预措施应针对血压控制和体重减轻。然而，尽管采取了多学科方法，生活方式的改变通常无法成功实现长期的血压和体重控制。对于非药物治疗失败、糖尿病、继发性高血压、2 期高血压或靶器官损伤的所有高血压儿童，都建议进行抗高血压治疗。
我们发现肥胖相关的高血压与心血管发病率和死亡率的显著增加相关，因此早期诊断和治疗以控制血压和减轻体重至关重要。
