Skip to main content

Advertisement

SpringerLink
Log in

Primary Hypertension in Childhood

  • Pediatric Hypertension (JT Flynn, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

There is growing concern about elevated blood pressure in children and adolescents, because of its association with the obesity epidemic. Moreover, cardiovascular function and blood pressure level are determined in childhood and track into adulthood. Primary hypertension in childhood is defined by persistent blood pressure values ≥ the 95th percentile and without a secondary cause. Preventable risk factors for elevated blood pressure in childhood are overweight, dietary habits, salt intake, sedentary lifestyle, poor sleep quality and passive smoking, whereas non-preventable risk factors include race, gender, genetic background, low birth weight, prematurity, and socioeconomic inequalities. Several different pathways are implicated in the development of primary hypertension, including obesity, insulin resistance, activation of the sympathetic nervous system, alterations in sodium homeostasis, renin-angiotensin system and altered vascular function. Prevention of adult cardiovascular disease should begin in childhood by regularly screening for high blood pressure, counseling for healthy lifestyle and avoiding preventable risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rosendorff C, Black HR, Cannon CP, et al. Treatment of hypertension in the prevention and management of ischemic heart disease: a scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation. 2007;115:2761–88.

    Article  PubMed  Google Scholar 

  2. McNiece KL, Poffenbarger TS, Turner JL, et al. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007;150:640–4. 644 e641.

    Article  PubMed  Google Scholar 

  3. Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens. 1995;8:657–65.

    Article  PubMed  CAS  Google Scholar 

  4. Beckett LA, Rosner B, Roche AF, Guo S. Serial changes in blood pressure from adolescence into adulthood. Am J Epidemiol. 1992;135:1166–77.

    PubMed  CAS  Google Scholar 

  5. Hofman A. Blood pressure in childhood: an epidemiological approach to the aetiology of hypertension. J Hypertens. 1984;2:323–8.

    PubMed  CAS  Google Scholar 

  6. Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation. 2008;117:3171–80.

    Article  PubMed  Google Scholar 

  7. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555–76.

    Article  Google Scholar 

  8. Simonetti GD, Rizzi M, Bianchetti MG. Simple references for managing arterial hypertension in children with kidney disease. J Hypertens. 2010;28:1109. author reply 1109–1110.

    Article  PubMed  CAS  Google Scholar 

  9. Somu S, Sundaram B, Kamalanathan AN. Early detection of hypertension in general practice. Arch Dis Child. 2003;88:302.

    Article  PubMed  CAS  Google Scholar 

  10. Lurbe E, Cifkova R, Cruickshank JK, et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009;27:1719–42.

    Article  PubMed  CAS  Google Scholar 

  11. Kapur G, Mattoo TK. Primary hypertension. In: Flynn JT, Ingelfinger JR, Portman RJ, editors. Pediatric hypertension. 2nd ed. New York: Springer–Humana Press; 2011. p. 343–56.

    Chapter  Google Scholar 

  12. Chiolero A, Cachat F, Burnier M, et al. Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. J Hypertens. 2007;25:2209–17.

    Article  PubMed  CAS  Google Scholar 

  13. Falkner B, Lurbe E, Schaefer F. High blood pressure in children: clinical and health policy implications. J Clin Hypertens (Greenwich). 2010;12:261–76.

    Article  Google Scholar 

  14. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298:874–9.

    Article  PubMed  CAS  Google Scholar 

  15. Brady TM, Solomon BS, Neu AM, et al. Patient-, provider-, and clinic-level predictors of unrecognized elevated blood pressure in children. Pediatrics. 2010;125:e1286–93.

    Article  PubMed  Google Scholar 

  16. Muntner P, He J, Cutler JA, et al. Trends in blood pressure among children and adolescents. JAMA. 2004;291:2107–13.

    Article  PubMed  CAS  Google Scholar 

  17. • Simonetti GD, Schwertz R, Klett M, et al. Determinants of blood pressure in preschool children: the role of parental smoking. Circulation. 2011;123:292–8. This report indicates that in healthy preschool children, parental smoking is an independent risk factor for higher blood pressure, adding to other familial and environmental risk factors.

    Article  PubMed  Google Scholar 

  18. • Chiolero A, Paradis G, Madeleine G, et al. Discordant secular trends in elevated blood pressure and obesity in children and adolescents in a rapidly developing country. Circulation. 2009;119:558–65. In developed countries, secular trend studies demonstrate that the increase in the prevalence of arterial hypertension in childhood is mainly due to the increase in the prevalence of obesity. Interestingly, this report shows that in developing countries, such as the Seychelles, the secular trend for these associations seems not to be present: while BMI increases over the years, BP seems to decrease. A tentative explanation for this discrepancy between industrialized and developing countries is the fact that the prevalence of overweight/obesity may need to reach a very high level before an effect on BP can be measured at a population level.

    Article  PubMed  Google Scholar 

  19. Flynn J, Zhang Y, Solar-Yohay S, Shi V. Clinical and demographic characteristics of children with hypertension. Hypertension. 2012;60:1047–54.

    Article  PubMed  CAS  Google Scholar 

  20. Rosner B, Prineas R, Daniels SR, Loggie J. Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. Am J Epidemiol. 2000;151:1007–19.

    Article  PubMed  CAS  Google Scholar 

  21. Archbold KH, Vasquez MM, Goodwin JL, Quan SF. Effects of sleep patterns and obesity on increases in blood pressure in a 5-year period: report from the Tucson Children's Assessment of Sleep Apnea Study. J Pediatr. 2012;161:26–30.

    Article  PubMed  Google Scholar 

  22. Javaheri S, Storfer-Isser A, Rosen CL, Redline S. Sleep quality and elevated blood pressure in adolescents. Circulation. 2008;118:1034–40.

    Article  PubMed  Google Scholar 

  23. Bixler EO, Vgontzas AN, Lin HM, et al. Blood pressure associated with sleep-disordered breathing in a population sample of children. Hypertension. 2008;52:841–6.

    Article  PubMed  CAS  Google Scholar 

  24. Stein DJ, Scott K, Haro Abad JM, et al. Early childhood adversity and later hypertension: data from the World Mental Health Survey. Ann Clin Psychiatry. 2010;22:19–28.

    PubMed  Google Scholar 

  25. Pludowski P, Litwin M, Niemirska A, et al. Accelarated skeletal maturation in children with primary hypertension. Hypertension. 2009;54:1234–9.

    Article  PubMed  CAS  Google Scholar 

  26. Brady TM, Fivush B, Parekh RS, Flynn JT. Racial differences among children with primary hypertension. Pediatrics. 2010;126:931–7.

    Article  PubMed  Google Scholar 

  27. Berenson GS, Chen W, Dasmahapatra P, et al. Stimulus response of blood pressure in black and white young individuals helps explain racial divergence in adult cardiovascular disease: the Bogalusa Heart Study. J Am Soc Hypertens. 2011;5:230–8.

    Article  PubMed  Google Scholar 

  28. Rodriguez-Moran M, Aradillas-Garcia C, Simental-Mendia LE, et al. Family history of hypertension and cardiovascular risk factors in prepubertal children. Am J Hypertens. 2010;23:299–304.

    Article  PubMed  Google Scholar 

  29. • Oikonen M, Tikkanen E, Juhola J, et al. Genetic variants and blood pressure in a population-based cohort: the Cardiovascular Risk in Young Finns study. Hypertension. 2011;58:1079–85. The findings of this study show that genetic variants are associated with preclinical blood pressure traits in childhood; individuals with several susceptibility alleles have, on average, a 0.5-mmHg higher blood pressure, and this tracking continues from childhood to adulthood.

    Article  PubMed  CAS  Google Scholar 

  30. Ajala AR, Almeida SS, Rangel M, et al. Association of ACE gene insertion/deletion polymorphism with birth weight, blood pressure levels, and ACE activity in healthy children. Am J Hypertens. 2012;25:827–32.

    Article  PubMed  CAS  Google Scholar 

  31. Bonamy AK, Kallen K, Norman M. High blood pressure in 2.5-year-old children born extremely preterm. Pediatrics. 2012;129:e1199–204.

    Article  PubMed  Google Scholar 

  32. Wolfenstetter A, Simonetti GD, Poschl J, et al. Altered cardiovascular rhythmicity in children born small for gestational age. Hypertension. 2012;60:865–70.

    Article  PubMed  CAS  Google Scholar 

  33. Nilsson PM, Lurbe E, Laurent S. The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome. J Hypertens. 2008;26:1049–57.

    Article  PubMed  CAS  Google Scholar 

  34. de Boer MP, Ijzerman RG, de Jongh RT, et al. Birth weight relates to salt sensitivity of blood pressure in healthy adults. Hypertension. 2008;51:928–32.

    Article  PubMed  Google Scholar 

  35. Rostand SG. Oligonephronia, primary hypertension and renal disease: 'is the child father to the man?'. Nephrol Dial Transplant. 2003;18:1434–8.

    Article  PubMed  Google Scholar 

  36. Simonetti GD, Raio L, Surbek D, et al. Salt sensitivity of children with low birth weight. Hypertension. 2008;52:625–30.

    Article  PubMed  CAS  Google Scholar 

  37. van den Berg G, van Eijsden M, Galindo-Garre F, et al. Explaining socioeconomic inequalities in childhood blood pressure and prehypertension: the ABCD study. Hypertension. 2013;61:35–41.

    Article  PubMed  Google Scholar 

  38. • Loeffler LF, Navas-Acien A, Brady TM, et al. Uric acid level and elevated blood pressure in US adolescents: National Health and Nutrition Examination Survey, 1999–2006. Hypertension. 2012;59:811–7. The results of this study show that increasing levels of serum uric acid are associated with elevated blood pressure in healthy adolescents. Compared with <5.5 mg/dL, participants with a uric acid level ≥ 5.5 mg/dl had a two times higher odds of having elevated blood pressure.

    Article  PubMed  CAS  Google Scholar 

  39. Shatat IF, Abdallah RT, Sas DJ, Hailpern SM. Serum uric acid in U.S. adolescents: distribution and relationship to demographic characteristics and cardiovascular risk factors. Pediatr Res. 2012. doi:10.1038/pr.2012.47.

    PubMed  Google Scholar 

  40. Prebis JW, Gruskin AB, Polinsky MS, Baluarte HJ. Uric acid in childhood essential hypertension. J Pediatr. 1981;98:702–7.

    Article  PubMed  CAS  Google Scholar 

  41. Feig DI. The role of uric acid in the pathogenesis of hypertension in the young. J Clin Hypertens (Greenwich). 2012;14:346–52.

    Article  CAS  Google Scholar 

  42. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial. JAMA. 2008;300:924–32.

    Article  PubMed  CAS  Google Scholar 

  43. Nguyen S, Choi HK, Lustig RH, Hsu CY. Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents. J Pediatr. 2009;154:807–13.

    Article  PubMed  CAS  Google Scholar 

  44. Karpinski L, Plaksej R, Derzhko R, et al. Serum levels of interleukin-6, interleukin-10 and C-reactive protein in patients with myocardial infarction treated with primary angioplasty during a 6-month follow-up. Pol Arch Med Wewn. 2009;119:115–21.

    PubMed  CAS  Google Scholar 

  45. Boring L, Gosling J, Cleary M, Charo IF. Decreased lesion formation in CCR2−/− mice reveals a role for chemokines in the initiation of atherosclerosis. Nature. 1998;394:894–7.

    Article  PubMed  CAS  Google Scholar 

  46. •• Beveridge LA, Witham MD. Vitamin D and the cardiovascular system. Osteoporos Int. 2013. doi:10.1007/s00198-013-2281-1. An interesting review about the effect of Vitamin D on the cardiovascular system.

    PubMed  Google Scholar 

  47. Hall JE, Mizelle HL, Hildebrandt DA, Brands MW. Abnormal pressure natriuresis. A cause or a consequence of hypertension? Hypertension. 1990;15:547–59.

    Article  PubMed  CAS  Google Scholar 

  48. Guyton A. Circulatory Physiology III: Arterial Pressure and Hypertension. Philadelphia: W.B. Saunders Company; 1980.

    Google Scholar 

  49. Amann K, Plank C, Dotsch J. Low nephron number–a new cardiovascular risk factor in children? Pediatr Nephrol. 2004;19:1319–23.

    Article  PubMed  Google Scholar 

  50. Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. Less of one, more the other? Am J Hypertens. 1988;1:335–47.

    Article  PubMed  CAS  Google Scholar 

  51. Keller G, Zimmer G, Mall G, et al. Nephron number in patients with primary hypertension. N Engl J Med. 2003;348:101–8.

    Article  PubMed  Google Scholar 

  52. Simonetti GD, Mohaupt MG, Bianchetti MG. Monogenic forms of hypertension. Eur J Pediatr. 2012;171:1433–9.

    Article  PubMed  CAS  Google Scholar 

  53. Tu W, Eckert GJ, DiMeglio LA, et al. Intensified effect of adiposity on blood pressure in overweight and obese children. Hypertension. 2011;58:818–24.

    Article  PubMed  CAS  Google Scholar 

  54. • Babinska K, Kovacs L, Janko V, et al. Association between obesity and the severity of ambulatory hypertension in children and adolescents. J Am Soc Hypertens. 2012;6:356–63. This study investigates the relationship between hypertension and degree of obesity in children aged 7 to 18 years. The severity of high blood pressure increased significantly with the degree of obesity. Daytime systolic, diastolic, and mean arterial BPs increased significantly with increased BMI, whereas the nighttime pressure remained elevated regardless of the degree of obesity.

    Article  PubMed  CAS  Google Scholar 

  55. Puri M, Flynn JT, Garcia M, et al. The frequency of elevated blood pressure in obese minority youth. J Clin Hypertens (Greenwich). 2008;10:119–24.

    Article  CAS  Google Scholar 

  56. 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;134:668–74.

    Article  PubMed  CAS  Google Scholar 

  57. Flynn J. The changing face of pediatric hypertension in the era of the childhood obesity epidemic. Pediatr Nephrol. 2013;28:1059–66.

    Article  PubMed  Google Scholar 

  58. Rademacher ER, Jacobs Jr DR, Moran A, et al. Relation of blood pressure and body mass index during childhood to cardiovascular risk factor levels in young adults. J Hypertens. 2009;27:1766–74.

    Article  PubMed  CAS  Google Scholar 

  59. Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management. Am J Hypertens. 2010;23:1170–8.

    Article  PubMed  CAS  Google Scholar 

  60. •• Kotsis V, Stabouli S, Papakatsika S, et al. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33:386–93. An important review about the pathophysiological mechanisms leading to arterial hypertension in obesity.

    Article  PubMed  Google Scholar 

  61. Shatat IF, Freeman KD, Vuguin PM, et al. Relationship between adiponectin and ambulatory blood pressure in obese adolescents. Pediatr Res. 2009;65:691–5.

    Article  PubMed  CAS  Google Scholar 

  62. Pacifico L, Anania C, Osborn JF, et al. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol. 2011;165:603–11.

    Article  PubMed  CAS  Google Scholar 

  63. Croix B, Feig DI. Childhood hypertension is not a silent disease. Pediatr Nephrol. 2006;21:527–32.

    Article  PubMed  Google Scholar 

  64. Thompson M, Dana T, Bougatsos C, et al. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics. 2013;131:490–525.

    Article  PubMed  Google Scholar 

  65. Daniels SR, Loggie JM, Khoury P, Kimball TR. Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation. 1998;97:1907–11.

    Article  PubMed  CAS  Google Scholar 

  66. Matteucci MC, Wuhl E, Picca S, et al. Left ventricular geometry in children with mild to moderate chronic renal insufficiency. J Am Soc Nephrol. 2006;17:218–26.

    Article  PubMed  Google Scholar 

  67. Urbina EM, Gidding SS, Bao W, et al. Effect of body size, ponderosity, and blood pressure on left ventricular growth in children and young adults in the Bogalusa Heart Study. Circulation. 1995;91:2400–6.

    Article  PubMed  CAS  Google Scholar 

  68. Lande MB, Meagher CC, Fisher SG, et al. Left ventricular mass index in children with white coat hypertension. J Pediatr. 2008;153:50–4.

    Article  PubMed  Google Scholar 

  69. Redwine KM, Daniels SR. Prehypertension in adolescents: risk and progression. J Clin Hypertens (Greenwich). 2012;14:360–4.

    Article  Google Scholar 

  70. Mitchell P, Cheung N, de Haseth K, et al. Blood pressure and retinal arteriolar narrowing in children. Hypertension. 2007;49:1156–62.

    Article  PubMed  CAS  Google Scholar 

  71. Li S, Chen W, Srinivasan SR, et al. Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA. 2003;290:2271–6.

    Article  PubMed  CAS  Google Scholar 

  72. Raitakari OT, Juonala M, Kahonen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003;290:2277–83.

    Article  PubMed  CAS  Google Scholar 

  73. Berenson GS, Srinivasan SR, Bao W, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338:1650–6.

    Article  PubMed  CAS  Google Scholar 

  74. Li S, Chen W, Srinivasan SR, Berenson GS. Childhood blood pressure as a predictor of arterial stiffness in young adults: the bogalusa heart study. Hypertension. 2004;43:541–6.

    Article  PubMed  Google Scholar 

  75. Simonetti GD, Vonv RO, Wuhl E, Mohaupt MG. Ambulatory arterial stiffness index is increased in hypertensive childhood disease. Pediatr Res. 2008;64:303–7.

    Article  PubMed  Google Scholar 

  76. Lande MB, Kaczorowski JM, Auinger P, et al. Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States. J Pediatr. 2003;143:720–4.

    Article  PubMed  Google Scholar 

  77. •• Lande MB, Kupferman JC, Adams HR. Neurocognitive alterations in hypertensive children and adolescents. J Clin Hypertens (Greenwich). 2012;14:353–9. This article reviews the evidence that children with hypertension manifest neurocognitive differences when compared with normotensive controls. Several studies suggest that children with hypertension manifest deficits on measures of neurocognition and have an increased prevalence of learning difficulties, and that children with hypertension associated with obesity may be at increased risk for depression and anxiety.

    Article  Google Scholar 

  78. Adams HR, Szilagyi PG, Gebhardt L, Lande MB. Learning and attention problems among children with pediatric primary hypertension. Pediatrics. 2010;126:e1425–9.

    Article  PubMed  Google Scholar 

  79. Wong LJ, Kupferman JC, Prohovnik I, et al. Hypertension impairs vascular reactivity in the pediatric brain. Stroke. 2011;42:1834–8.

    Article  PubMed  Google Scholar 

  80. Seeman T, Pohl M, Palyzova D, John U. Microalbuminuria in children with primary and white-coat hypertension. Pediatr Nephrol. 2012;27:461–7.

    Article  PubMed  Google Scholar 

  81. Hanevold CD, Pollock JS, Harshfield GA. Racial differences in microalbumin excretion in healthy adolescents. Hypertension. 2008;51:334–8.

    Article  PubMed  CAS  Google Scholar 

  82. Nguyen S, McCulloch C, Brakeman P, et al. Being overweight modifies the association between cardiovascular risk factors and microalbuminuria in adolescents. Pediatrics. 2008;121:37–45.

    Article  PubMed  Google Scholar 

  83. Bibbins-Domingo K, Coxson P, Pletcher MJ, et al. Adolescent overweight and future adult coronary heart disease. N Engl J Med. 2007;357:2371–9.

    Article  PubMed  CAS  Google Scholar 

  84. Daniels SR. Is there an epidemic of cardiovascular disease on the horizon? J Pediatr. 1999;134:665–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Barbara S. Bucher contributed to conception of this review, literature search and analysis. She drafted the initial manuscript with Alessandra Ferrarini, and she approved the final manuscript as submitted. Alessandra Ferrarini contributed to conception of this review, literature search and analysis. Ms. Ferrarini drafted the initial manuscript with Dr. Bucher and approved the final manuscript as submitted. Nico Weber contributed to literature search and analysis, and approved the final manuscript as submitted. Marina Bullo contributed to literature search and analysis, and approved the final manuscript as submitted. Mario G. Bianchetti contributed to conception of this review, revised the article critically for important intellectual content, and gave final approval of the version to be published. Giacomo D. Simonetti contributed to conception of this review, literature search, supervision and coordination. Dr. Simonetti reviewed and revised the article critically for important intellectual content, and gave final approval of the version to be published.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Barbara S. Bucher, Alessandra Ferrarini, Nico Weber, Marina Bullo, Mario G. Bianchetti, and Giacomo D. Simonetti 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.

Author information

Authors and Affiliations

  1. Pediatric Nephrology, University Children’s Hospital, Inselspital and University of Bern, 3010, Bern, Switzerland

    Barbara S. Bucher, Nico Weber, Marina Bullo & Giacomo D. Simonetti

  2. Department of Pediatrics, Ospedale Regionale Bellinzona e Valli and University of Bern, Bern, Switzerland

    Alessandra Ferrarini, Marina Bullo & Mario G. Bianchetti

Authors
  1. Barbara S. Bucher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra Ferrarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nico Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marina Bullo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mario G. Bianchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giacomo D. Simonetti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giacomo D. Simonetti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bucher, B.S., Ferrarini, A., Weber, N. et al. Primary Hypertension in Childhood. Curr Hypertens Rep 15, 444–452 (2013). https://doi.org/10.1007/s11906-013-0378-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-013-0378-8

Keywords

Search

Navigation