Department of Paediatrics, University of Chieti, 66100 Chieti, Italy.
Curr Hypertens Rev. 2024;20(2):80-89. doi: 10.2174/0115734021305332240712103602.
Hypertension is a real problem in children. It shows a tracking behaviour, representing a key risk factor for hypertension, cardiovascular disease, and end-organ failure in adulthood. However, the importance of addressing arterial hypertension in children is not limited to its risk of tracking into adulthood. Thus, early detection and management are crucial. Hypertension may be primary or due to secondary causes, and identification of this distinction is very important for the treatment setting. Importantly, the management of hypertension in children is crucial to prevent the well-known cardiovascular effects in adulthood. As demonstrated in the literature, healthy eating habits, together with regular physical activity, can have a major impact on reducing high blood pressure and preventing organ damage in children and adolescents. However, suppose these are not sufficient to treat hypertension. In that case, if patients are symptomatic and/or have additional metabolic conditions such as obesity, type diabetes mellitus, or chronic kidney disease, anti-hypertensive medication must be started. Recent guidelines have provided clear guidance on the treatment of hypertension and hypertensive crisis in pediatric age. On the other hand, there are currently few specific recommendations on the treatment of isolated nocturnal hypertension and treatment- resistant hypertension. This review aims to summarize the most recent recommendations for the treatment of hypertension and hypertensive crisis in children and the last years' knowledge and experience in treating childhood isolated nocturnal hypertension and resistant hypertension of childhood.
高血压是儿童面临的一个实际问题。它呈现出一种跟踪行为，是成年后患高血压、心血管疾病和终末器官衰竭的一个关键风险因素。然而，解决儿童动脉高血压的重要性不仅限于其向成年期发展的风险。因此，早期发现和管理至关重要。高血压可能是原发性的，也可能是继发性的，确定这种区别对治疗方案非常重要。重要的是，儿童高血压的管理对于预防众所周知的成年期心血管影响至关重要。正如文献中所证明的，健康的饮食习惯，加上有规律的体育活动，对降低儿童和青少年的高血压和预防器官损伤有重大影响。但是，如果这些不足以治疗高血压。在这种情况下，如果患者有症状和/或有其他代谢疾病，如肥胖、2 型糖尿病或慢性肾病，则必须开始使用抗高血压药物。最近的指南为儿童高血压和高血压危象的治疗提供了明确的指导。另一方面，目前对于单纯夜间高血压和治疗抵抗性高血压的治疗，仅有少量具体的建议。本综述旨在总结儿童高血压和高血压危象治疗的最新建议，以及近年来在治疗儿童单纯夜间高血压和儿童治疗抵抗性高血压方面的知识和经验。
