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Lifestyle Interventions for Elevated Blood Pressure in Childhood—Approaches and Outcomes

  • Pediatric Hypertension (C Hanevold, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to provide an overview of existing and emerging lifestyle treatments in the clinical management of primary elevated blood pressure and hypertension in pediatric patients. The authors hope to expand the knowledge base surrounding pediatric hypertension and update clinicians on best practices to improve outcomes.

Recent Findings

Elevated blood pressure is traditionally addressed with broad lifestyle recommendations such as limiting salt consumption and losing weight. This approach is not well adapted for pediatric patients. Novel and often underutilized approaches to the treatment of hypertension in pediatrics include psychological counseling for behavior modification, circadian nutrition, consistent use of interdisciplinary teams, manipulation of macronutrients, stress management, technology-infused interventions, and systemic changes to the food environment.

Summary

Elevated blood pressure is a pervasive condition affecting cardiovascular disease and mortality risk. Increasingly, pediatric patients are presenting with elevated blood pressure with etiologies known to be affected by lifestyle behaviors. Weight management, dietary modifications, and daily physical activity are well-researched methods for improving individual blood pressure measurements. These strategies can sometimes be as effective as pharmacological interventions at lowering blood pressure. However, compliance with these individual recommendations is not consistent and has led to unsatisfactory results. There are emerging treatment trends that may provide non-traditional and more effective non-pharmacologic routes to blood pressure management in pediatric patients.

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Abbreviations

BP:

Blood pressure

EBP:

Elevated blood pressure

HTN:

Hypertension

DASH:

Dietary approaches to stop hypertension

AAP:

American Association of Pediatrics

RAAS:

Renin-angiotensin-aldosterone system

Na:K:

Sodium-potassium ratio

ACE:

Angiotensin-converting enzyme

CVD:

Cardiovascular disease

AI:

Adequate intake

NHANES:

National Health and Nutrition Examination Survey

BMI:

Body mass index

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Authors and Affiliations

  1. Pediatric Nephrology, University Health System, San Antonio, TX, USA

    C. Austin Lobitz

  2. Pediatric Nephrology, University of Oklahoma Health Science Center and Oklahoma Children’s Hospital, OU Health, Oklahoma City, OK, USA

    Ikuyo Yamaguchi

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Correspondence to C. Austin Lobitz.

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Lobitz, C.A., Yamaguchi, I. Lifestyle Interventions for Elevated Blood Pressure in Childhood—Approaches and Outcomes. Curr Hypertens Rep 24, 589–598 (2022). https://doi.org/10.1007/s11906-022-01217-1

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