Obstetric and Pediatric Pharmacology and Therapeutics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development,
School of Medicine, University of Maryland, Baltimore, Maryland.
Pediatrics. 2019 May;143(5). doi: 10.1542/peds.2018-3517.
Hypertension affects >40% of the US population and is a major contributor to cardiovascular-related morbidity and mortality. Although less common among children and adolescents, hypertension affects 1% to 5% of all youth. The 2017 Clinical Practice Guideline for the Diagnosis and Management of High Blood Pressure in Children and Adolescents provided updates and strategies regarding the diagnosis and management of hypertension in youth. Despite this important information, many gaps in knowledge remain, such as the etiology, prevalence, and trends of hypertension; the utility and practicality of ambulatory blood pressure monitoring; practical goals for lifestyle modification that are generalizable; the long-term end-organ impacts of hypertension in youth; and the long-term safety and efficacy of antihypertensive therapy in youth. The National Institute of Child Health and Human Development, in collaboration with the National Heart, Lung, and Blood Institute and the US Food and Drug Administration, sponsored a workshop of experts to discuss the current state of childhood primary hypertension. We highlight the results of that workshop and aim to (1) provide an overview of current practices related to the diagnosis, management, and treatment of primary pediatric hypertension; (2) identify related research gaps; and (3) propose ways to address existing research gaps.
高血压影响超过 40%的美国人口,是导致心血管相关发病率和死亡率的主要因素。尽管在儿童和青少年中较为少见,但高血压影响所有青少年的 1%至 5%。2017 年《儿童和青少年高血压诊断和管理临床实践指南》提供了更新和策略,用于诊断和管理青少年高血压。尽管有这些重要信息,但仍存在许多知识空白,例如高血压的病因、患病率和趋势;动态血压监测的实用性和实用性;可推广的生活方式改变的实用目标;高血压对青年终末器官的长期影响;以及青少年抗高血压治疗的长期安全性和疗效。美国国立儿童健康与人类发展研究所与国家心肺血液研究所和美国食品和药物管理局合作,举办了一次专家研讨会,讨论儿童原发性高血压的现状。我们重点介绍了该研讨会的结果,并旨在(1)概述与原发性儿科高血压的诊断、管理和治疗相关的当前实践;(2)确定相关的研究空白;(3)提出解决现有研究空白的方法。