Pediatric Nephrology, University Health System, San Antonio, TX, USA.
Pediatric Nephrology, University of Oklahoma Health Science Center and Oklahoma Children's Hospital, OU Health, Oklahoma City, OK, USA.
Curr Hypertens Rep. 2022 Nov;24(11):589-598. doi: 10.1007/s11906-022-01217-1. Epub 2022 Aug 16.
The purpose of this review is to provide an overview of existing and emerging lifestyle treatments in the clinical management of primary elevated blood pressure and hypertension in pediatric patients. The authors hope to expand the knowledge base surrounding pediatric hypertension and update clinicians on best practices to improve outcomes.
Elevated blood pressure is traditionally addressed with broad lifestyle recommendations such as limiting salt consumption and losing weight. This approach is not well adapted for pediatric patients. Novel and often underutilized approaches to the treatment of hypertension in pediatrics include psychological counseling for behavior modification, circadian nutrition, consistent use of interdisciplinary teams, manipulation of macronutrients, stress management, technology-infused interventions, and systemic changes to the food environment. Elevated blood pressure is a pervasive condition affecting cardiovascular disease and mortality risk. Increasingly, pediatric patients are presenting with elevated blood pressure with etiologies known to be affected by lifestyle behaviors. Weight management, dietary modifications, and daily physical activity are well-researched methods for improving individual blood pressure measurements. These strategies can sometimes be as effective as pharmacological interventions at lowering blood pressure. However, compliance with these individual recommendations is not consistent and has led to unsatisfactory results. There are emerging treatment trends that may provide non-traditional and more effective non-pharmacologic routes to blood pressure management in pediatric patients.
综述目的： 本篇综述旨在介绍原发性高血压和儿科高血压患者临床管理中现有和新兴的生活方式治疗方法。作者希望扩展儿科高血压的知识库，并为临床医生提供改善治疗效果的最佳实践方法。
最新发现：传统上，高血压是通过广泛的生活方式建议来治疗的，如限制盐的摄入和减肥。然而，这种方法并不适用于儿科患者。儿科高血压治疗的新颖且常未充分利用的方法包括行为改变的心理辅导、昼夜节律营养、综合使用多学科团队、调整宏量营养素、压力管理、技术辅助干预，以及对食物环境进行系统性改变。高血压是一种普遍存在的疾病，会影响心血管疾病和死亡率风险。越来越多的儿科患者出现了已知受生活方式行为影响的高血压。体重管理、饮食调整和日常体育活动是改善个体血压测量的经过充分研究的方法。这些策略有时与降压药物干预一样有效。然而，这些单独建议的依从性并不一致，导致结果并不令人满意。目前出现了一些新兴的治疗趋势，可能为儿科患者的血压管理提供非传统和更有效的非药物治疗途径。
