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Hypertension in Older Adolescents and Young Adults

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Pediatric Hypertension

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Abstract

Hypertension is the most prevalent modifiable risk factor for cardiovascular disease events worldwide. Among older adolescents and young adults, the prevalence of hypertension has grown in recent years and now exceeds 20%. In part, this recent increase in prevalence is due to the publication in 2017 of revised clinical practice guidelines for the evaluation and treatment of hypertension for both children and adults that include lower blood pressure (BP) thresholds for the definition of hypertension. Hypertension diagnosed in late adolescence and young adulthood confers long-term increased risk of adverse cardiovascular disease events and should be treated in the same way and with the same attention to achieve blood pressure targets as for older adults. Special attention should be paid to young adults with elevated BP (systolic BP 120–129 mm Hg and diastolic BP <80), as research has shown that many of these individuals go on to develop frank hypertension within a few years. As in older adults, primary or essential hypertension is the most common etiology of hypertension in older adolescents and young adults. Among those with secondary causes of hypertension, the most common etiologies are renal parenchymal diseases and renovascular diseases. Data from clinical trials on the relationship between BP targets and cardiovascular disease events in older adolescents and young adults are lacking. Nonetheless, current clinical practice guidelines recommend targeting a BP of <130/80 mm Hg for any adult treated with drug therapy for hypertension, including young adults. In this chapter, the epidemiology, outcomes, evaluation, and treatment of hypertension among older adolescents and young adults 18 to approximately 30 years of age are reviewed.

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, WA, USA

    Matthew B. Rivara

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Editors and Affiliations

  1. Division of Nephrology, Seattle Children's Hospital, Seattle, WA, USA

    Joseph T. Flynn

  2. Massachusetts General Hospital, Boston, MA, USA

    Julie R. Ingelfinger

  3. Johns Hopkins University, Baltimore, MD, USA

    Tammy Brady

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  1. University of Washington School of Medicine, Seattle, WA, USA

    Joseph T. Flynn MD, MS

  2. Divison of Nephrology, Seattle Children’s Hospital, Seattle, WA, USA

    Joseph T. Flynn MD, MS

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Rivara, M.B. (2022). Hypertension in Older Adolescents and Young Adults. In: Flynn, J.T., Ingelfinger, J.R., Brady, T. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-31420-4_52-2

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  1. Latest

    Hypertension in Older Adolescents and Young Adults
    Published:
    27 March 2022

    DOI: https://doi.org/10.1007/978-3-319-31420-4_52-2

  2. Original

    Hypertension in Older Adolescents and Young Adults
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    26 April 2017

    DOI: https://doi.org/10.1007/978-3-319-31420-4_52-1

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