Lurbe Empar, Mancia Giuseppe, Calpe Javier, Drożdż Dorota, Erdine Serap, Fernandez-Aranda Fernando, Hadjipanayis Adamos, Hoyer Peter F, Jankauskiene Augustina, Jiménez-Murcia Susana, Litwin Mieczysław, Mazur Artur, Pall Denes, Seeman Tomas, Sinha Manish D, Simonetti Giacomo, Stabouli Stella, Wühl Elke
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
Department of Pediatric, Consorcio Hospital General, University of Valencia, Valencia, Spain.
Front Pediatr. 2023 Apr 11;11:1140357. doi: 10.3389/fped.2023.1140357. 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. The first and most important requirement for the diagnosis and management of hypertension is an accurate measurement of office blood pressure that is currently recommended for screening, diagnosis, and management of high blood pressure in children and adolescents. Blood pressure levels should be screened in all children starting from the age of 3 years. In those children with risk factors for high blood pressure, it should be measured at each medical visit and may start before the age of 3 years. Twenty-four-hour ambulatory blood pressure monitoring is increasingly recognized as an important source of information as it can detect alterations in circadian and short-term blood pressure variations and identify specific phenotypes such as nocturnal hypertension or non-dipping pattern, morning blood pressure surge, white coat and masked hypertension with prognostic significance. At present, home BP measurements are generally regarded as useful and complementary to office and 24-h ambulatory blood pressure for the evaluation of the effectiveness and safety of antihypertensive treatment and furthermore remains more accessible in primary care than 24-h ambulatory blood pressure. A grading system of the clinical evidence is included.
这份联合声明是HyperChildNET与欧洲儿科学会之间就青少年高血压诊断与管理开展的协同行动，以2016年发布的欧洲高血压学会指南为基础，旨在促进该指南的实施。高血压诊断与管理的首要且最重要的要求是准确测量诊室血压，目前这被推荐用于儿童和青少年高血压的筛查、诊断及管理。所有3岁及以上儿童均应进行血压水平筛查。对于有高血压危险因素的儿童，每次就诊时都应测量血压，且可能在3岁之前就开始测量。动态血压监测越来越被视为重要的信息来源，因为它能检测昼夜及短期血压变化，并识别具有预后意义的特定表型，如夜间高血压或非勺型血压模式、清晨血压激增、白大衣高血压和隐蔽性高血压。目前，家庭血压测量通常被认为对评估降压治疗的有效性和安全性有用且具有补充作用，此外，在初级保健中，家庭血压测量比动态血压监测更容易获得。文中包含了临床证据的分级系统。
