Wühl Elke, Calpe Javier, Drożdż Dorota, Erdine Serap, Fernandez-Aranda Fernando, Hadjipanayis Adamos, Hoyer Peter F, Jankauskiene Augustina, Jiménez-Murcia Susana, Litwin Mieczysław, Mancia Giuseppe, Mazur Artur, Pall Denes, Seeman Tomas, Sinha Manish D, Simonetti Giacomo, Stabouli Stella, Lurbe Empar
Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Analog Devices, Inc., Paterna, Spain.
Front Pediatr. 2023 Apr 12;11:1140617. doi: 10.3389/fped.2023.1140617. eCollection 2023.
The joint statement is a synergistic action between HyperChildNET and the European Academy of Pediatrics about the diagnosis and management of hypertension in youth, based on the European Society of Hypertension Guidelines published in 2016 with the aim to improve its implementation. Arterial hypertension is not only the most important risk factor for cardiovascular morbidity and mortality, but also the most important modifiable risk factor. Early hypertension-mediated organ damage may already occur in childhood. The duration of existing hypertension plays an important role in risk assessment, and structural and functional organ changes may still be reversible or postponed with timely treatment. Therefore, appropriate therapy should be initiated in children as soon as the diagnosis of arterial hypertension has been confirmed and the risk factors for hypertension-mediated organ damage have been thoroughly evaluated. Lifestyle measures should be recommended in all hypertensive children and adolescents, including a healthy diet, regular exercise, and weight loss, if appropriate. If lifestyle changes in patients with primary hypertension do not result in normalization of blood pressure within six to twelve months or if secondary or symptomatic hypertension or hypertension-mediated organ damage is already present, pharmacologic therapy is required. Regular follow-up to assess blood pressure control and hypertension-mediated organ damage and to evaluate adherence and side effects of pharmacologic treatment is required. Timely multidisciplinary evaluation is recommended after the first suspicion of hypertension. A grading system of the clinical evidence is included.
这份联合声明是HyperChildNET与欧洲儿科学会针对青少年高血压的诊断和管理采取的协同行动，它基于2016年发布的欧洲高血压学会指南，旨在推动该指南的实施。动脉高血压不仅是心血管疾病发病和死亡的最重要危险因素，也是最重要的可改变危险因素。高血压介导的早期器官损害可能在儿童期就已出现。现有高血压的持续时间在风险评估中起着重要作用，通过及时治疗，器官的结构和功能改变仍可能可逆或延缓。因此，一旦确诊动脉高血压并全面评估了高血压介导的器官损害危险因素，就应尽早对儿童开始适当治疗。对于所有高血压儿童和青少年，都应推荐采取生活方式干预措施，包括健康饮食、定期锻炼，以及必要时进行体重控制。如果原发性高血压患者通过改变生活方式在6至12个月内血压仍未恢复正常，或者已经出现继发性或症状性高血压或高血压介导的器官损害，则需要进行药物治疗。需要定期随访，以评估血压控制情况、高血压介导的器官损害情况，并评估药物治疗的依从性和副作用。首次怀疑高血压后，建议及时进行多学科评估。声明还包含了临床证据的分级系统。
