Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Lancet Child Adolesc Health. 2021 May;5(5):357-366. doi: 10.1016/S2352-4642(20)30344-8. Epub 2021 Mar 10.
Hypertension is a major modifiable cardiovascular disease risk factor and its presence in childhood is associated with the presence and burden of atherosclerosis. Moreover, hypertension tracks from childhood to adulthood and is associated with adverse cardiac changes and vascular damage that in turn are associated with premature cardiovascular disease in adulthood. Therefore, the early identification and effective treatment of hypertension in children and adolescents is key in the primordial and primary prevention of cardiovascular disease, particularly for at-risk individuals, such as those with obesity, diabetes, or chronic kidney disease, among others. Unfortunately, hypertension can be difficult to diagnose in children and adolescents and is as such frequently under-recognised. In this Review, we provide an overview of hypertension in adolescents, with a focus on its prevalence and diagnosis, the rationale for early identification and treatment, and current knowledge gaps.
高血压是一个主要的可改变的心血管疾病风险因素，其在儿童期的存在与动脉粥样硬化的存在和负担有关。此外，高血压从儿童期一直持续到成年期，与不良的心脏变化和血管损伤有关，而这些又与成年期的心血管疾病过早发生有关。因此，在心血管疾病的原始和一级预防中，早期识别和有效治疗儿童和青少年的高血压是关键，特别是对于肥胖、糖尿病或慢性肾脏病等高危人群。不幸的是，儿童和青少年的高血压可能难以诊断，因此常常被忽视。在这篇综述中，我们概述了青少年高血压，重点介绍其患病率和诊断、早期识别和治疗的基本原理，以及当前的知识空白。
