Heart Failure in Severely Hypertensive Children

Abstract

High blood pressure (BP) is a clearly established, but modifiable, risk factor for early disability and death. Although most of the adverse outcomes occur in adulthood, it has become clear that high blood pressure is a life course problem that can become evident in early life. While few would dispute the importance of taking effective steps to identify and manage this condition in middle-aged and older people, relatively little attention has been paid to the problem of high blood pressure in children and adolescents. Although long considered a disease of aging, its prevalence is increasing in children and adolescents. Unlike in adults, hypertension (HTN) is not a common cause of heart failure in children and adolescents, even though the presence of severe hypertension is a condition in which congestive heart failure can be present. Acute severe hypertension should be evaluated emergently, and treatment should be instituted without delay to reduce risks such as severe elevation of blood pressure in a child, which may lead to devastating complications. Several available drugs have been shown to be safe and effective in children with severe hypertension, although more research is needed to guide the management of these patients.