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当高血压“长大”后:青少年和青年高血压患者从儿科保健提供者过渡到成人保健提供者的护理的相关影响。

When Hypertension Grows Up: Implications for Transitioning Care of Adolescents and Young Adults With Hypertension From Pediatric to Adult Health Care Providers.

机构信息

East Tennessee Children's Hospital, Knoxville, TN; Department of Medicine, University of Tennessee Health Science Center-College of Medicine, Knoxville, TN.

Department of Pediatrics, Keck School of Medicine, Division of Nephrology, Children's Hospital Los Angeles, Los Angeles, CA.

出版信息

Adv Chronic Kidney Dis. 2022 May;29(3):263-274. doi: 10.1053/j.ackd.2021.11.005.

Abstract

Hypertension (HTN) is an important cause of morbidity and mortality in children as well as adults. HTN and related adverse cardiovascular health develop and progress on a continuum across an individual's life course. Pediatric HTN, or even isolated elevated blood pressure as a child, increases the risk of sustained HTN and cardiovascular disease in later adulthood. Transitioning the care of adolescents and young adults who have HTN is an important but unmet health care need that could potentially have a dramatic effect on mitigating the risk of cardiovascular disease in adulthood. However, very little has been published about the transition process in this population, and considerable gaps in the field remain. We discuss the epidemiology, etiology, and management approach in youth with HTN and how they differ from adults. We contextualize HTN and cardiovascular health on a continuum across the life course. We discuss key considerations for the transition process for adolescents and young adults with HTN including the major barriers that exist. Finally, we review key immediate health care needs that are particularly important around the time of the transfer of care.

摘要

高血压(HTN)是儿童和成人发病率和死亡率的重要原因。HTN 及相关心血管健康不良在个体的整个生命过程中呈连续发展和进展。儿科高血压,甚至儿童时期单纯的血压升高,会增加成年后持续高血压和心血管疾病的风险。患有高血压的青少年和年轻人的护理过渡是一个重要但未满足的医疗保健需求,这可能会对减轻成年人心血管疾病风险产生巨大影响。然而,关于这一人群的过渡过程,几乎没有什么出版物,该领域仍然存在很大差距。我们讨论了患有 HTN 的年轻人的流行病学、病因和管理方法,以及它们与成年人的不同之处。我们将 HTN 和心血管健康置于整个生命过程的连续体中。我们讨论了患有 HTN 的青少年和年轻人过渡过程的关键注意事项,包括存在的主要障碍。最后,我们回顾了在转移护理时特别重要的关键即时医疗保健需求。

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