Hypertension in children and adolescents.

Definition and management of arterial hypertension in children and adolescents are uncertain, due to different positions of current guidelines. The European Society of Cardiology task-force, constituted by Associations and Councils with interest in arterial hypertension, has reviewed current literature and evidence, to produce a Consensus Document focused on aspects of hypertension in the age range of 6-16 years, including definition, methods of measurement of blood pressure, clinical evaluation, assessment of hypertension-mediated target organ damage, evaluation of possible vascular, renal and hormonal causes, assessment and management of concomitant risk factors with specific attention for obesity, and anti-hypertensive strategies, especially focused on life-style modifications. The Consensus Panel also suggests aspects that should be studied with high priority, including generation of multi-ethnic sex, age and height specific European normative tables, implementation of randomized clinical trials on different diagnostic and therapeutic aspects, and long-term cohort studies to link with adult cardiovascular risk. Finally, suggestions for the successful implementation of the contents of the present Consensus document are also given.

[1]  S. Daniels,et al.  Pediatric Ambulatory Blood Pressure Classification: The Case for a Change. , 2021, Hypertension.

[2]  A. D. De Moraes,et al.  Blood pressure measurement in pediatric population: comparison between automated oscillometric devices and mercury sphygmomanometers—a systematic review and meta-analysis , 2021, European Journal of Pediatrics.

[3]  P. Gosse,et al.  Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension , 2021, Journal of hypertension.

[4]  E. Urbina,et al.  Impact of the 2017 American Academy of Pediatrics’ Clinical Practice Guideline on the Identification and Risk Stratification of Youth at Increased Cardiovascular Disease Risk , 2021, Hypertension.

[5]  G. Parati,et al.  2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. , 2021, Journal of hypertension.

[6]  W. Cushman,et al.  KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. , 2021, Kidney international.

[7]  P. Srivaths,et al.  Reclassification of adolescent hypertension by ambulatory blood pressure monitoring using adult norms and association with left ventricular hypertrophy , 2021, Journal of clinical hypertension.

[8]  Paras P. Shah,et al.  Comparison of Pediatric and Adult Ambulatory Blood Pressure Monitoring Criteria for the Diagnosis of Hypertension and Detection of Left Ventricular Hypertrophy in Adolescents. , 2020, The Journal of pediatrics.

[9]  W. Young,et al.  Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study. , 2020, The lancet. Diabetes & endocrinology.

[10]  D. Kaelber,et al.  Hypertensive Crisis in Pediatric Patients: An Overview , 2020, Frontiers in Pediatrics.

[11]  C. Magnussen,et al.  Weight change from childhood to adulthood and cardiovascular risk factors and outcomes in adulthood: A systematic review of the literature , 2020, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[12]  Ashley A. Knapp,et al.  Optimizing the implementation of a population panel management intervention in safety-net clinics for pediatric hypertension (The OpTIMISe–Pediatric Hypertension Study) , 2020, Implementation Science Communications.

[13]  Matthew R. Williams,et al.  Electrocardiogram Standards for Children and Young Adults Using Z-Scores , 2020, Circulation. Arrhythmia and electrophysiology.

[14]  Lawrence A Leiter,et al.  Hypertension Canada's 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. , 2020, The Canadian journal of cardiology.

[15]  G. Parati,et al.  How to Apply European and American Guidelines on High Blood Pressure in Children and Adolescents. A Position Paper Endorsed by the Italian Society of Hypertension and the Italian Society of Pediatrics , 2020, High Blood Pressure & Cardiovascular Prevention.

[16]  R. Kelishadi,et al.  International waist circumference percentile cut-offs for central obesity in children and adolescents aged 6-18 years. , 2019, The Journal of clinical endocrinology and metabolism.

[17]  G. Parati,et al.  STRIDE BP international initiative for accurate blood pressure measurement: Systematic review of published validation studies of blood pressure measuring devices , 2019, Journal of clinical hypertension.

[18]  K. Rahimi,et al.  Global Prevalence of Hypertension in Children: A Systematic Review and Meta-analysis. , 2019, JAMA pediatrics.

[19]  J. Flynn,et al.  Implications of the 2017 AAP Clinical Practice Guidelines for Management of Hypertension in Children and Adolescents: a Review , 2019, Current Hypertension Reports.

[20]  S. Rifas-Shiman,et al.  Metabolic trajectories across early adolescence: differences by sex, weight, pubertal status and race/ethnicity , 2019, Annals of human biology.

[21]  G. de Simone,et al.  Impact of the 2017 Blood Pressure Guidelines by the American Academy of Pediatrics in overweight/obese youth. , 2019, Journal of hypertension.

[22]  J. Steinberger,et al.  Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association. , 2019, Circulation.

[23]  K. Goffin,et al.  Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children , 2019, Pediatric Nephrology.

[24]  Nuala M Byrne,et al.  Precision medicine and healthy living: The importance of the built environment. , 2019, Progress in cardiovascular diseases.

[25]  Sabine J. Roza,et al.  Association of Blood Pressure and Arterial Stiffness With Cognition in 2 Population‐Based Child and Adult Cohorts , 2018, Journal of the American Heart Association.

[26]  T. Seeman,et al.  Hypertensive crisis in children and adolescents , 2018, Pediatric Nephrology.

[27]  G. Lip,et al.  ESC Council on hypertension position document on the management of hypertensive emergencies. , 2018, European heart journal. Cardiovascular pharmacotherapy.

[28]  G. Lip,et al.  2018 ESC/ESH Guidelines for the management of arterial hypertension. , 2018, European heart journal.

[29]  F. D’Ascenzo,et al.  Pharmacological Treatment of Arterial Hypertension in Children and Adolescents: A Network Meta-Analysis , 2018, Hypertension.

[30]  M. Litwin,et al.  Insights and implications of new blood pressure guidelines in children and adolescents. , 2018, Journal of hypertension.

[31]  D. Metzger,et al.  Prevalence and Severity of High Blood Pressure Among Children Based on the 2017 American Academy of Pediatrics Guidelines , 2018, JAMA pediatrics.

[32]  T. Links,et al.  Incidence of pheochromocytoma and sympathetic paraganglioma in the Netherlands: A nationwide study and systematic review. , 2018, European journal of internal medicine.

[33]  G. Parati,et al.  Aldosterone-to-renin ratio depends on age and sex in children attending a clinic for cardiovascular risk assessment , 2018, Journal of hypertension.

[34]  R. Brook,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Journal of the American Society of Hypertension : JASH.

[35]  Brandon K. Fornwalt,et al.  Ambulatory systolic blood pressure and obesity are independently associated with left ventricular hypertrophic remodeling in children , 2017, Journal of Cardiovascular Magnetic Resonance.

[36]  B. Dobbs,et al.  Secondary Hypertension: Discovering the Underlying Cause. , 2017, American family physician.

[37]  S. Daniels,et al.  Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents , 2017, Pediatrics.

[38]  E. Goodman,et al.  The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering , 2017, Pediatrics.

[39]  T. Lehtimäki,et al.  Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study. , 2017, Journal of the American College of Cardiology.

[40]  W. Chin,et al.  Moving toward a paradigm shift in the regulatory requirements for pediatric medicines , 2016, European Journal of Pediatrics.

[41]  A. Dominiczak,et al.  2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. , 2016, Journal of hypertension.

[42]  F. Becherucci,et al.  Chronic kidney disease in children , 2016, Clinical kidney journal.

[43]  J. Flynn Microalbuminuria in Children With Primary Hypertension , 2016, Journal of clinical hypertension.

[44]  A. Doyon,et al.  Left Ventricular Mass Indexing in Infants, Children, and Adolescents: A Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical Practice. , 2016, The Journal of pediatrics.

[45]  J. Breda,et al.  Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI–2008) , 2016, International Journal of Obesity.

[46]  C. Tudor-Locke,et al.  The epidemiological transition and the global childhood obesity epidemic. , 2015, International journal of obesity supplements.

[47]  G. Stergiou,et al.  Changing relationship among clinic, home, and ambulatory blood pressure with increasing age. , 2015, Journal of the American Society of Hypertension : JASH.

[48]  F. Pieruzzi,et al.  The role of blood pressure, body weight and fat distribution on left ventricular mass, diastolic function and cardiac geometry in children , 2015, Journal of Hypertension.

[49]  R. Oberhoffer,et al.  Intima media thickness measurement in children: A statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. , 2015, Atherosclerosis.

[50]  L. Mayhew,et al.  Waist-to-Height Ratio Is More Predictive of Years of Life Lost than Body Mass Index , 2014, PloS one.

[51]  P. D. de Leeuw,et al.  European consensus on the diagnosis and management of fibromuscular dysplasia. , 2014, Journal of hypertension.

[52]  S. Daniels,et al.  Update: Ambulatory Blood Pressure Monitoring in Children and Adolescents A Scientific Statement From the American Heart Association , 2014, Hypertension.

[53]  P. Salice,et al.  Differences between office and ambulatory blood pressures in children and adolescents attending a hospital hypertension clinic , 2013, Journal of hypertension.

[54]  P. Brambilla,et al.  Serum Uric Acid and Blood Pressure in Children at Cardiovascular Risk , 2013, Pediatrics.

[55]  J. Flynn The changing face of pediatric hypertension in the era of the childhood obesity epidemic , 2013, Pediatric Nephrology.

[56]  B. Heidari,et al.  A Comparison between International Obesity Task Force and Center for Disease Control References in Assessment of Overweight and Obesity Among Adolescents in Babol, Northern Iran , 2013, International journal of preventive medicine.

[57]  B. Ranchin,et al.  Schwartz Formula: Is One k-Coefficient Adequate for All Children? , 2012, PloS one.

[58]  J. Flynn,et al.  Clinical and Demographic Characteristics of Children With Hypertension , 2012, Hypertension.

[59]  I. Lupescu,et al.  Fibromuscular dysplasia – a rare cause of renovascular hypertension. Case study and overview of the literature data , 2012, Journal of medicine and life.

[60]  S. Daniels Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatrics.

[61]  V. Mericq,et al.  Frequency of Familial Hyperaldosteronism Type 1 in a Hypertensive Pediatric Population: Clinical and Biochemical Presentation , 2011, Hypertension.

[62]  H. Hense,et al.  Blood Pressure Percentiles by Age and Height From Nonoverweight Children and Adolescents in Germany , 2011, Pediatrics.

[63]  T. Laitinen,et al.  Pediatric Metabolic Syndrome Predicts Adulthood Metabolic Syndrome, Subclinical Atherosclerosis, and Type 2 Diabetes Mellitus but Is No Better Than Body Mass Index Alone: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study , 2010, Circulation.

[64]  B. Solomon,et al.  Patient-, Provider-, and Clinic-Level Predictors of Unrecognized Elevated Blood Pressure in Children , 2010, Pediatrics.

[65]  A. Anarat,et al.  Strict blood-pressure control and progression of renal failure in children. , 2009, The New England journal of medicine.

[66]  Patrick Segers,et al.  Role of pulse pressure amplification in arterial hypertension: experts' opinion and review of the data. , 2009, Hypertension.

[67]  B. Falkner,et al.  Should the current approach to the evaluation and treatment of high blood pressure in children be changed? , 2009, The Journal of pediatrics.

[68]  B. Alpert,et al.  Pre-hypertension and hypertension in pediatrics: don't let the statistics hide the pathology. , 2009, The Journal of pediatrics.

[69]  S. Daniels,et al.  Age-specific reference intervals for indexed left ventricular mass in children. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[70]  Matthew J Strickland,et al.  Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. , 2008, The Journal of pediatrics.

[71]  B. Howard,et al.  Cardiac markers of pre-clinical disease in adolescents with the metabolic syndrome: the strong heart study. , 2008, Journal of the American College of Cardiology.

[72]  S. Colan,et al.  A Novel Method of Expressing Left Ventricular Mass Relative to Body Size in Children , 2007, Circulation.

[73]  David C Kaelber,et al.  Underdiagnosis of hypertension in children and adolescents. , 2007, JAMA.

[74]  D. Panagiotakos,et al.  Home blood pressure normalcy in children and adolescents: the Arsakeion School study , 2007, Journal of hypertension.

[75]  A. Marelli,et al.  Congenital Heart Disease in the General Population: Changing Prevalence and Age Distribution , 2006, Circulation.

[76]  R. Califf,et al.  Racial differences are seen in blood pressure response to fosinopril in hypertensive children. , 2006, American heart journal.

[77]  Yasmin,et al.  Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). , 2005, Journal of the American College of Cardiology.

[78]  H. D. D. Waal,et al.  Secular Trend of Timing of Puberty , 2005 .

[79]  S. Daniels,et al.  Evaluation of Concentric Left Ventricular Geometry in Humans: Evidence for Age-Related Systematic Underestimation , 2005, Hypertension.

[80]  Isabel Rey Madeira,et al.  The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. , 2004, Pediatrics.

[81]  Richard J. Johnson,et al.  Hyperuricemia in Childhood Primary Hypertension , 2003, Hypertension.

[82]  Youfa Wang,et al.  A comparison of international references for the assessment of child and adolescent overweight and obesity in different populations† , 2002, European Journal of Clinical Nutrition.

[83]  J. Graves Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. , 2002, Journal of hypertension.

[84]  J. Cockcroft,et al.  Pressure Amplification Explains Why Pulse Pressure Is Unrelated to Risk in Young Subjects , 2001, Hypertension.

[85]  S. Grundy Primary prevention of coronary heart disease: integrating risk assessment with intervention. , 1999, Circulation.

[86]  G. de Simone,et al.  Relations of left ventricular geometry and function to body composition in children with high casual blood pressure. , 1997, Hypertension.

[87]  P. Okin,et al.  Regression of left ventricular hypertrophy as a surrogate end-point for morbid events in hypertension treatment trials , 1996, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[88]  E. Boerwinkle,et al.  Essential hypertension vs. secondary hypertension among children. , 2015, American journal of hypertension.

[89]  R. Jackson,et al.  Contributions of built environment to childhood obesity. , 2011, The Mount Sinai journal of medicine, New York.

[90]  W. Dietz,et al.  Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. , 2007, The Journal of pediatrics.

[91]  E. Waters,et al.  Interventions for preventing obesity in children. , 2001, The Cochrane database of systematic reviews.