Pediatric Hypertension: Impact on the Heart, Brain, Kidney, and Retina

  • Jovanka Vasilevska-Ristovska
  • Shawn Z. Hudes
  • Kirtiga Naguleswaran
  • Valerie Langlois
  • Mina Matsuda-Abedini
  • Rulan S. Parekh
Pediatrics
  • 1 Downloads
Part of the following topical collections:
  1. Topical Collection on Pediatrics

Abstract

Purpose of Review

Pediatric hypertension is increasing in incidence with concomitant increases in childhood obesity. Target organ damage from primary or secondary pediatric hypertension is a growing concern, as the pathogenesis of vascular disease, typically observed later in life, may begin at a young age. While hypertensive complications are described extensively in adults, much less is known about end organ damage from elevated blood pressure in children and adolescents.

Recent Findings

This review highlights the recent advances describing the target organ damage in the macro- and microvasculature resulting from hypertension. Persistently elevated blood pressure in childhood is associated with vascular changes affecting the heart, brain, kidneys, and retina. Emerging research shows that elevated blood pressure in children has effect on neurocognitive function in specific domains such as executive functioning, attention, and memory. Microalbuminuria is an early marker of kidney disease and a sign of glomerular injury and endothelial dysfunction that increases the risk of kidney damage and is associated with future kidney and cardiovascular events. Screening with ambulatory blood pressure monitoring to improve blood pressure control and echocardiogram may aid in early prevention of end organ damage.

Summary

In this review, we summarize and critically evaluate recent findings, describe ongoing studies, and address future research questions. Implications for diagnosis, prognosis, and need for better control of hypertension are also discussed.

Keywords

Pediatric hypertension Essential hypertension Target organ damage End organ damage Blood pressure 

Notes

Compliance with Ethical Standards

Conflict of Interest

Jovanka Vasilevska-Ristovska, Shawn Hudes, Kirtiga Naguleswaran, Valerie Langlois, Mina Matsuda-Abedini, and Rulan Parekh declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jovanka Vasilevska-Ristovska
    • 1
  • Shawn Z. Hudes
    • 1
    • 2
  • Kirtiga Naguleswaran
    • 1
    • 3
  • Valerie Langlois
    • 4
    • 5
  • Mina Matsuda-Abedini
    • 4
    • 5
  • Rulan S. Parekh
    • 1
    • 4
    • 5
    • 6
  1. 1.Child Health Evaluative Sciences, Research InstituteHospital for Sick ChildrenTorontoCanada
  2. 2.Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland
  3. 3.Royal College of Surgeons in IrelandDublin 2Ireland
  4. 4.Division of Pediatric NephrologyHospital for Sick ChildrenTorontoCanada
  5. 5.Department of PaediatricsUniversity of TorontoTorontoCanada
  6. 6.Division of NephrologyUniversity Health NetworkTorontoCanada

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