Title:Treatment of Hypertension in Children
Volume: 20
Issue: 2
Author(s): Francesca Mainieri*, Veronica Maria Tagi and Francesco Chiarelli
Affiliation:
- Department of Paediatrics, University of Chieti, 66100 Chieti, Italy
Keywords:
Hypertension, cardiovascular diseases, children, hypertensive crisis, resistant hypertension, isolated nocturnal hypertension.
Abstract: 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.
