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儿童和青少年高血压。

Hypertension in Children and Young Adults.

机构信息

Department of Paediatric Nephrology, Evelina London Children's Hospital, Guys & St Thomas NHS Foundation Trust, Westminster Bridge Road, 3rd Floor Beckett House, London SE1 7EH, United Kingdom; Kings College London, United Kingdom.

Department of Paediatric Nephrology, Evelina London Children's Hospital, Guys & St Thomas NHS Foundation Trust, Westminster Bridge Road, 3rd Floor Beckett House, London SE1 7EH, United Kingdom; Kings College London, United Kingdom.

出版信息

Pediatr Clin North Am. 2022 Dec;69(6):1165-1180. doi: 10.1016/j.pcl.2022.07.005. Epub 2022 Oct 29.

Abstract

Primary hypertension (PH) is most common during adolescence with increasing prevalence globally, alongside the epidemic of obesity. Unlike in adults, there are no data on children with uncontrolled hypertension and their future risk of hard cardiovascular and cerebrovascular outcomes. However, hypertension in childhood is linked to hypertensive-mediated organ damage (HMOD) which is often reversible if treated appropriately. Despite differing guidelines regarding the threshold for defining hypertension, there is consensus that early recognition and prompt management with lifestyle modification escalating to antihypertensive medication is required to ameliorate adverse outcomes. Unfortunately, many unknowns remain regarding pathophysiology and optimum treatment of childhood hypertension.

摘要

原发性高血压(PH)在青少年中最为常见,在全球范围内其发病率呈上升趋势,同时肥胖症也在流行。与成年人不同,目前尚无关于未经控制的高血压儿童及其未来发生硬性心血管和脑血管不良结局风险的数据。然而,儿童期高血压与高血压介导的器官损伤(HMOD)有关,如果适当治疗,HMOD 通常是可逆的。尽管关于定义高血压的阈值存在不同的指南,但共识认为需要早期识别和及时管理,包括生活方式改变和升阶梯至降压药物治疗,以改善不良结局。不幸的是,儿童期高血压的病理生理学和最佳治疗方法仍有许多未知。

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