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Cardiovascular Influences on Blood Pressure

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Pediatric Hypertension

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Abstract

The study of hemodynamic mechanisms in children and young people with primary hypertension has been neglected historically. An understanding of the abnormalities in the function of the large arteries, the left ventricle, and their interaction may be important to elucidate the development and observed effects of hypertension. In this chapter, we discuss cardiovascular influences that determine blood pressure; highlighting the static and pulsatile components of blood pressure and review the published literature evaluating hemodynamics in children with hypertension. We compare findings in hypertensive children with those with normotension. Increasing data support a cardiac and large artery component in early hypertension in children and young people. Increase in cardiac output appears to be the earliest identifiable abnormality in children and young people (CYP) with increased systemic vascular resistance (SVR) in hypertensive young adults. Given the tracking of hypertension from children to adults, the finding of a cardiac/aortic rather than peripheral vascular changes associated with primary hypertension has implications for the etiology of hypertension both in children and adults. It also has implications for the best treatment in children.

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Authors and Affiliations

  1. Department of Paediatric Nephrology, Evelina London Children’s Hospital, Guys & St Thomas’ NHS Foundation Trust, London, UK

    Manish D. Sinha

  2. Kings College London British Heart Foundation Centre, London, UK

    Manish D. Sinha & Phil Chowienczyk

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  1. Manish D. Sinha
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  2. Phil Chowienczyk
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Correspondence to Manish D. Sinha .

Editor information

Editors and Affiliations

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

    Joseph T. Flynn

  2. Pediatric Nephrology Unit, Mass General for Children at MGB Harvard Medical School, Boston, MA, USA

    Julie R. Ingelfinger

  3. Department of Pediatrics Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Tammy M. Brady

Section Editor information

  1. Pediatric Nephrology Unit, MassGeneral Hospital for Children at MGH, Harvard Medical School, Boston, MA, USA

    Julie R. Ingelfinger M.D.

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Sinha, M.D., Chowienczyk, P. (2023). Cardiovascular Influences on Blood Pressure. In: Flynn, J.T., Ingelfinger, J.R., Brady, T.M. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-031-06231-5_3

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  • DOI: https://doi.org/10.1007/978-3-031-06231-5_3

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