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What’s new in pediatric hypertension?

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Abstract

Research activities in the field of pediatric hypertension have been increasing in recent years, leading to important new findings in the epidemiology, diagnosis, and treatment of hypertension in children. This review summarizes recent work in these areas, focusing on the epidemic of obesity-related hypertension in children, advances in the drug therapy of childhood hypertension, and the increasing use of ambulatory blood pressure monitoring in evaluation of hypertensive children. Each of these three areas will no doubt develop further over the years ahead, resulting in further advances in the field of childhood hypertension.

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References and Recommended Reading

  1. Vogt BA: Hypertension in children and adolescents: definition, pathophysiology, risk factors, and long-term sequelae. Curr Ther Res Clin Exp 2001, 62:283–297.

    Article  Google Scholar 

  2. Silverberg DS, Van Nostrand C, Juchli B, et al.: Screening for hypertension in a high school population. Can Med Assoc J 1975, 113:103–108.

    PubMed  CAS  Google Scholar 

  3. Fixler DE, Laird WP, Fitzgerald V, et al.: Hypertension screening in schools: results of the Dallas study. Pediatrics 1979, 63:32–36.

    PubMed  CAS  Google Scholar 

  4. Sinaiko AR, Gomez-Martin O, Prineas RJ: Prevalence of "significant" hypertension in junior and high school-aged children: the children and adolescent blood pressure program. J Pediatr 1989, 114:664–669.

    Article  PubMed  CAS  Google Scholar 

  5. Adrogué HE, Sinaiko AR: Prevalence of hypertension in junior high school-aged children: effect of new recommendations in the 1996 updated Task Force report. Am J Hypertens 2001, 14:412–414. Demonstrates that application of the new standards for childhood blood pressure as revised by the working group did not change the prevalence of hypertension in an unselected population of otherwise healthy children.

    Article  PubMed  Google Scholar 

  6. Feld LG, Springate JE: Hypertension in children. Curr Probl Pediatr 1988, 18:317–373.

    Article  PubMed  CAS  Google Scholar 

  7. Arar MY, Hogg RJ, Arant BS Jr, Seikaly MG: Etiology of sustained hypertension in children in the southwestern United States. Pediatr Nephrol 1994, 8:186–189.

    Article  PubMed  CAS  Google Scholar 

  8. Flynn JT: Characteristics of children with primary hypertension referred to a tertiary center [abstract]. Am J Hypertens 2001, 14:239A.

    Article  Google Scholar 

  9. Rosner B, Prineas R, Loggie J, Daniels SR: Percentiles for body mass index in U.S. children 5 to 17 years of age. J Pediatr 1998, 132:211–222.

    Article  PubMed  CAS  Google Scholar 

  10. Troiano RP, Flegal KM, Kuczmarski RJ, et al.: Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adoles Med 1995, 149:1085–1091.

    CAS  Google Scholar 

  11. Mokdad AH, Serdula MK, Dietz WH, et al.: The spread of the obesity epidemic in the United States, 1991–1998. J Am Med Assoc 1999, 282:1519–1522. Highlights the increasing prevalence of obesity in American adults.

    Article  CAS  Google Scholar 

  12. Lauer RM, Clarke WR: Childhood risk factors for high adult blood pressure: the Muscatine study. Pediatrics 1984, 84:633–641.

    Google Scholar 

  13. Luepker RV, Jacobs DR, Prineas RJ, Sinaiko AR: Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986 to 1996. J Pediatr 1999, 134:668–674. Extremely important article demonstrating that the increasing body size of American children is being accompanied by an increase in blood pressure.

    Article  PubMed  CAS  Google Scholar 

  14. Sorof JM, Eissa MA, Bernard L, Portman RJ: High hypertension prevalence and the relationship of body mass index to blood pressure in ethnic minority children [abstract]. Am J Hypertens 2001, 14:14A.

    Article  Google Scholar 

  15. Sinaiko AR, Donahue RP, Jacobs Jr DR, Prineas RJ: Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults: the Minneapolis children’s blood pressure study. Circulation 1999, 99:1471–1476.

    PubMed  CAS  Google Scholar 

  16. Daniels SR: Is there an epidemic of cardiovascular disease on the horizon? J Pediatr 1999, 134:665–666.

    Article  PubMed  CAS  Google Scholar 

  17. The Trials of Hypertension Prevention Collaborative Research Group: Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. Arch Intern Med 1997, 157:657–67.

    Article  Google Scholar 

  18. Flynn JT: Pediatric use of antihypertensive medications: much more to learn. Curr Ther Res Clin Exp 2001, 62:314–328.

    Article  CAS  Google Scholar 

  19. Wells TG: Trials of antihypertensive therapies in children. Blood Press Monit 1999, 4:189–192. Review of the issues related to pediatric antihypertensive drug trials, and to the FDAMA of 1997.

    Article  PubMed  CAS  Google Scholar 

  20. Mirkin BL, Newman TJ: Efficacy of captopril in the treatment of severe childhood hypertension: report of the International Collaborative Study Group. Pediatrics 1985, 75:1091–1100.

    PubMed  CAS  Google Scholar 

  21. Sinaiko AR, O’Dea RF, Mirkin BL: Clinical response of hypertensive children to long-term minoxidil therapy. J Cardiovasc Pharmacol 1980, 2(Suppl 2):S181-S188.

    Article  PubMed  Google Scholar 

  22. Physicians’ Desk Reference, 54th ed. Montvale, NJ: Medical Economics Company; 2000.

  23. Temple ME, Nahata MC: Treatment of pediatric hypertension. Pharmacotherapy 2000, 20:140–150.

    Article  PubMed  CAS  Google Scholar 

  24. Nahata MC: Lack of pediatric drug formulations. Pediatrics 1999, 104:607–609.

    PubMed  CAS  Google Scholar 

  25. Flynn JT, Pasko DA: Calcium channel blockers: pharmacology and place in therapy of pediatric hypertension. Pediatr Nephrol 2000, 15:302–316. A comprehensive review of the pharmacology and therapeutic use of this class of antihypertensive in children.

    Article  PubMed  CAS  Google Scholar 

  26. Wells TG, Sinaiko AR: Antihypertensive effect and pharmacokinetics of nitrendipine in children. J Pediatr 1991, 118:638–643.

    Article  PubMed  CAS  Google Scholar 

  27. Khattak S, Rogan JW, Saunder EF, et al.: Efficacy of amlodipine in pediatric bone marrow transplant patients. Clin Pediatr 1998, 37:31–35.

    CAS  Google Scholar 

  28. Pfammatter JF, Clericetti-Affolter C, Trittmann AC, et al.: Amlodipine once-daily in systemic hypertension. Eur J Pediatr 1998, 157:618–621.

    Article  PubMed  CAS  Google Scholar 

  29. Tallian KB, Nahata MC, Turman MA, et al.: Efficacy of amlodipine in pediatric patients with hypertension. Pediatr Nephrol 1999, 13:304–310.

    Article  PubMed  CAS  Google Scholar 

  30. Rogan JW, Lyszkiewicz DA, Blowey D, et al.: A randomized prospective crossover trial of amlodipine in pediatric hypertension. Pediatr Nephrol 2000, 14:1083–1087.

    Article  PubMed  CAS  Google Scholar 

  31. Flynn JT, Smoyer WE, Bunchman TE: Treatment of hypertensive children with amlodipine. Am J Hypertens 2000, 13:1061–1066. Retrospective study demonstrating an inverse relationship in children between effective amlodipine dose and body weight.

    Article  PubMed  CAS  Google Scholar 

  32. Miller K, Santanello N, Kolman C, et al.: Pediatric use chart review study [abstract]. Am J Hypertens 2000, 13:285A.

    Article  Google Scholar 

  33. Soffer BA, Shahinfar S, Shaw WC, et al.: Effects of the Ace inhibitor, enalapril, in children age 6-16 years with hypertension [abstract]. Pediatr Res 2000, 47:452A.

    Google Scholar 

  34. Shahinfar S, Rippley R, Hogg R, et al.: Multicenter study of enalapril pharmacokinetics in hypertensive children and infants [abstract]. Pediatr Res 2000, 47:473A.

    Google Scholar 

  35. Cunningham RJ, Urbina EM, Hogg RJ, et al.: A double-blind, placebo-controlled, dose escalation safety and efficacy study of Ziac in patients ages 6-17 years with hypertension [abstract]. Am J Hypertens 2000, 13:38A.

    Article  Google Scholar 

  36. The Task Force on Blood Pressure Control in Childhood: Report of the Task Force. Pediatrics 1977, 59:797–820.

    Google Scholar 

  37. Task force on Blood Pressure Control in Children: Report of the second task force on blood pressure control in children - 1987. Pediatrics 1987, 79:1–25.

    Google Scholar 

  38. National High Blood Pressure Education Program Working Group: Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: A working group report from the National High Blood Pressure Education Program. Pediatrics 1996, 98:649–658.

    Google Scholar 

  39. Portman RJ, Yetman RJ: Clinical uses of ambulatory blood pressure monitoring. Pediatr Nephrol 1994, 8:367–376.

    Article  PubMed  CAS  Google Scholar 

  40. Bald M, Kubel S, Rascher W: Validity and reliability of 24h blood pressure monitoring in children and adolescents using a portable, oscillometric device. J Hum Hypertens 1994, 8:363–366.

    PubMed  CAS  Google Scholar 

  41. Lurbe E, Redon J: Ambulatory blood pressure monitoring in children and adolescents: the future. J Hypertens 2000, 18:1351–1354. Summarizes many of the issues hindering the routine use of ABPM in children.

    Article  PubMed  CAS  Google Scholar 

  42. Pickering TG: Ambulatory blood pressure monitoring. Curr Hypertens Rep 2000, 2:558–564.

    PubMed  CAS  Google Scholar 

  43. Koch VH, Furusawa EA, Saito MI, et al.: White coat hypertension in adolescents. Clin Nephrol 1999, 52:297–303. First study of the routine use of ABPM in hypertensive children. Demonstrates the utility of ABPM to diagnose WCH in this age group.

    PubMed  CAS  Google Scholar 

  44. Sorof JM, Portman RJ: White coat hypertension in children with elevated casual blood pressure. J Pediatr 2000, 137:493–497. This study examines the criteria used to diagnose WCH in children by ABPM, demonstrating that this diagnosis is not as straightforward as previously thought.

    Article  PubMed  CAS  Google Scholar 

  45. Baumgart P, Walger P, Dorst KG, et al.: Can secondary hypertension be identified by twenty-four-hour ambulatory pressure monitoring? J Hypertens 1989, 7(Suppl):S25-S28.

    Article  CAS  Google Scholar 

  46. Flynn JT: Use of ambulatory blood pressure monitoring to differentiate between primary and secondary hypertension in children [abstract]. Pediatr Res 2000, 47:446A.

    Google Scholar 

  47. Belsha CW, Wells TG, McNiece KL, et al.: Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens 1998, 11:410–417.

    Article  PubMed  CAS  Google Scholar 

  48. Harshfield GA, Pulliam DA, Alpert BS: Ambulatory blood pressure and renal function in healthy children and adolescents. Am J Hypertens 1994, 7:282–285.

    PubMed  CAS  Google Scholar 

  49. Sorof JM, Mielke TR, Portman RJ: Ambulatory blood pressure monitoring data are correlated with LV mass index and predictive of LV hypertrophy in children with hypertension [abstract]. Am J Hypertens 2000, 13:39A.

    Article  Google Scholar 

  50. Grin JM, McCabe EJ, White WB: Management of hypertension after ambulatory blood pressure monitoring. Ann Intern Med 1993, 118:833–837.

    PubMed  CAS  Google Scholar 

  51. Flynn JT: Impact of ambulatory blood pressure monitoring on the management of hypertension in children. Blood Press Monit 2000, 5:211–216. Another study examining the impact of routine use of ABPM in hypertensive children, demonstrating that decisions based on ABPM were different than those based on casual blood pressure.

    Article  PubMed  CAS  Google Scholar 

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  1. Pediatric Nephrology, Montefiore Medical Center, 111 East 210th Street, 10467, Bronx, NY, USA

    Joseph T. Flynn MD

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  1. Joseph T. Flynn MD
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Flynn, J.T. What’s new in pediatric hypertension?. Current Science Inc 3, 503–510 (2001). https://doi.org/10.1007/s11906-001-0013-y

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  • DOI: https://doi.org/10.1007/s11906-001-0013-y

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