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Management of high blood pressure in children: similarities and differences between US and European guidelines

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Abstract

Over the last several decades, many seminal longitudinal cohort studies have clearly shown that the antecedents to adult disease have their origins in childhood. Hypertension (HTN), which has become increasingly prevalent in childhood, represents one of the most important risk factors for cardiovascular diseases (CVD) such as heart disease and stroke. With the risk of adult HTN much greater when HTN is manifest in childhood, the future burden of CVD worldwide is therefore concerning. In an effort to slow the current trajectory, professional societies have called for more rigorous, evidence-based guideline development to aid primary care providers and subspecialists in improving recognition, diagnosis, evaluation, and treatment of pediatric HTN. In 2016 the European Society of Hypertension and in 2017 the American Academy of Pediatrics published updated guidelines for prevention and management of high blood pressure (BP) in children. While there are many similarities between the two guidelines, important differences exist. These differences, along with the identified knowledge gaps in each, will hopefully spur clinical researchers to action. This review highlights some of these similarities and differences, focusing on several of the more important facets regarding prevalence, prevention, diagnosis, management, and treatment of childhood HTN.

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Funding

This work was supported in part by the Fondazione E. Balli and the Swiss Research Network of Clinical Pediatric Hubs (SwissPedNet) (SG, ASG). Dr. Brady is supported by the NIH/NHLBI (HL119622-01).

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Johns Hopkins University, David M. Rubenstein Child Health Building, 200 N. Wolfe Street, Baltimore, MD, 21287, USA

    Tammy M. Brady

  2. Institute of Pediatrics of Southern Switzerland, Bellinzona, Switzerland

    Amalia Stefani-Glücksberg & Giacomo D. Simonetti

  3. Università della Svizzera Italiana, Lugano, Switzerland

    Giacomo D. Simonetti

Authors
  1. Tammy M. Brady
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  2. Amalia Stefani-Glücksberg
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  3. Giacomo D. Simonetti
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Correspondence to Tammy M. Brady.

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Multiple choice questions—answers:

1)c; 2)b; 3)a; 4)d; 5)d

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Brady, T.M., Stefani-Glücksberg, A. & Simonetti, G.D. Management of high blood pressure in children: similarities and differences between US and European guidelines. Pediatr Nephrol 34, 405–412 (2019). https://doi.org/10.1007/s00467-018-3946-y

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  • DOI: https://doi.org/10.1007/s00467-018-3946-y

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