Management of childhood hypertension.

The pathogenesis of primary hypertension remains unknown despite extensive investigation. Recent publications provide evidence that primary hypertension may have its inception in childhood or possibly in infancy. Longitudinal studies are needed to determine whether the infant and child with primary hypertension becomes a hypertensive adult. What is also needed is a genetic marker other than elevated blood pressure that may specifically identify the primary hypertensive person. We recommend nonpharmacologic therapeutic intervention in the pediatric patient with primary hypertension. More intensive investigation of pediatric patients with primary hypertension should be encouraged and supported. The complex puzzle of primary hypertension is more likely to be solved if discovered at the inception of the disease in infancy or childhood rather than in the later irreversible stage in adulthood.