Second Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece.
Fourth Department of Paediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
Curr Pharm Des. 2020;26(43):5591-5608. doi: 10.2174/1381612826666201113103614.
Hypertension in childhood and adolescence has increased in prevalence. Interest in the disease was raised after the 2017 clinical practice guidelines of the American Academy of Paediatrics on the definition and classification of paediatric hypertension. Among the secondary causes of paediatric hypertension, endocrine causes are relatively rare but important due to their unique treatment options. Excess of catecholamine, glucocorticoids and mineralocorticoids, congenital adrenal hyperplasia, hyperaldosteronism, hyperthyroidism and other rare syndromes with specific genetic defects are endocrine disorders leading to paediatric and adolescent hypertension. Adipose tissue is currently considered the major endocrine gland. Obesity-related hypertension constitutes a distinct clinical entity leading to an endocrine disorder. The dramatic increase in the rates of obesity during childhood has resulted in a rise in obesity-related hypertension among children, leading to increased cardiovascular risk and associated increased morbidity and mortality. This review presents an overview of pathophysiology and diagnosis of hypertension resulting from hormonal excess, as well as obesity-related hypertension during childhood and adolescence, with a special focus on management.
儿童和青少年的高血压患病率有所增加。在美国儿科学会 2017 年关于儿童高血压定义和分类的临床实践指南发布后，人们对该疾病的兴趣有所提高。在儿童高血压的继发性病因中，内分泌原因相对较少见，但由于其具有独特的治疗选择，因此非常重要。儿茶酚胺、糖皮质激素和盐皮质激素过多、先天性肾上腺皮质增生症、醛固酮增多症、甲状腺功能亢进症和其他具有特定遗传缺陷的罕见综合征等内分泌紊乱会导致儿童和青少年高血压。脂肪组织目前被认为是主要的内分泌腺。肥胖相关的高血压构成了一种独特的临床实体，导致内分泌紊乱。儿童期肥胖率的急剧增加导致肥胖相关的高血压在儿童中增加，导致心血管风险增加，并伴有发病率和死亡率增加。本综述介绍了由激素过多引起的高血压和儿童及青少年肥胖相关高血压的病理生理学和诊断概述，特别关注管理。
