Divisão de Clínica Médica e Divisão de Endocrinologia e Metabolismo do Departamento de Medicina da Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil,
Divisão de Endocrinologia e Metabolismo do Departamento de Medicina da Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp); Ambulatório de Adrenal da Divisão de Endocrinologia da Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de Sorocaba (PUC-Sorocaba), Sorocaba, SP, Brasil.
Arch Endocrinol Metab. 2022 Nov 17;66(6):895-907. doi: 10.20945/2359-3997000000507. Epub 2022 Aug 4.
High blood pressure (BP) is not restricted to adults; children and adolescents may also be affected, albeit less frequently. Aside from unfavorable environmental factors, such as obesity and sedentary life leading to early-onset essential hypertension (HT), several secondary causes must be investigated in the occasional hypertensive child/adolescent. Endocrine causes are relevant and multiple, related to the pituitary, thyroid, parathyroid, gonads, insulin, and others, but generally are associated with adrenal disease. This common scenario has several vital components, such as aldosterone, deoxycorticosterone (DOC), cortisol, or catecholamines, but there are also monogenic disorders involving the kidney tubule that cause inappropriate salt retention and HT that simulate adrenal disease. Finally, a blood vessel disease was recently described that may also participate in this vast spectrum of pediatric hypertensive disease. This review will shed some light on the diagnosis and management of conditions, focusing on the most prevalent adrenal (or adrenal-like) disturbances causing HT.
高血压（BP）不仅局限于成年人；儿童和青少年也可能受到影响，尽管频率较低。除了肥胖和久坐不动等不良环境因素导致儿童期原发性高血压（HT）提前发生外，偶尔出现高血压的儿童/青少年还需要调查一些继发性原因。内分泌原因是相关的，有多种原因与垂体、甲状腺、甲状旁腺、性腺、胰岛素等有关，但通常与肾上腺疾病有关。这种常见情况有几个重要组成部分，如醛固酮、脱氧皮质酮（DOC）、皮质醇或儿茶酚胺，但也有涉及肾小管的单基因疾病导致不适当的盐潴留和模拟肾上腺疾病的 HT。最后，最近描述了一种血管疾病，它也可能参与到这一大范围的儿科高血压疾病中。这篇综述将重点介绍最常见的导致 HT 的肾上腺（或类似肾上腺）功能紊乱的诊断和治疗方法。
