Nadciśnienie tętnicze u dzieci
Rokowania, prognozy i postęp choroby

Nadciśnienie tętnicze u dzieci stanowi rosnący problem zdrowotny, z częstością występowania około 6%, a u dzieci z otyłością sięgającą 30%. Nadciśnienie w tej grupie wiekowej wiąże się z uszkodzeniami narządowymi, takimi jak przerost lewej komory serca (LVH) oraz zwiększona grubość kompleksu intima-media tętnicy szyjnej, co predysponuje do chorób układu sercowo-naczyniowego i niewydolności nerek. W badaniu izraelskich rekrutów wojskowych stwierdzono, że nadciśnienie w okresie dojrzewania podwaja ryzyko długoterminowej niewydolności nerek (skorygowany współczynnik ryzyka 1,98; 95% CI 1,42-2,77), mimo niskiego bezwzględnego ryzyka (0,5%). U dzieci z przewlekłą chorobą nerek (PChN) nadciśnienie jest silnym czynnikiem progresji do niewydolności nerek, a jego kontrola zapobiega dalszemu pogorszeniu funkcji nerek. Ponadto, nadciśnienie w dzieciństwie utrzymuje się w wieku dorosłym i jest związane z przedwczesną chorobą sercowo-naczyniową, co potwierdzają badania podłużne wskazujące na umiarkowaną predykcyjność wysokiego ciśnienia krwi w dzieciństwie dla nadciśnienia w dorosłości.

  1. Nadciśnienie tętnicze u dzieci – rokowanie (przewidywanie wyników)
    1. Konsekwencje nadciśnienia w dzieciństwie
    2. Śledzenie nadciśnienia od dzieciństwa do dorosłości
    3. Czynniki wpływające na rokowanie
    4. Modele predykcyjne i wczesna identyfikacja
    5. Znaczenie wczesnego wykrywania i leczenia
    6. Cele terapeutyczne i postępowanie
  2. Wnioski i zalecenia
    1. Kolejne rozdziały

Nadciśnienie tętnicze u dzieci – rokowanie (przewidywanie wyników)

Nadciśnienie tętnicze u dzieci stanowi poważne zagrożenie dla zdrowia publicznego, którego częstość występowania znacząco wzrosła w ostatnich dekadach. Według dostępnych danych, częstość występowania podwyższonego ciśnienia tętniczego i nadciśnienia u dzieci wynosi około 6%, czyli po 3% dla każdego z tych stanów. Wśród młodzieży z otyłością częstość ta wzrasta prawie pięciokrotnie, osiągając około 30%. 1 Szacuje się, że ogólna częstość występowania nadciśnienia tętniczego u dzieci wynosi między 1% a 4%, przy czym wskaźniki są wyższe u nastolatków w porównaniu z młodszymi dziećmi. 2 Szczególnym niepokojem napawa fakt, że mimo rosnącej częstości występowania i potencjalnych zagrożeń związanych z nadciśnieniem u dzieci, diagnoza jest często przeoczana. 3

Konsekwencje nadciśnienia w dzieciństwie

Nadciśnienie tętnicze u dzieci związane jest z uszkodzeniami narządowymi, które z kolei wiążą się z przyszłymi chorobami układu sercowo-naczyniowego. 4 Dzieci z nadciśnieniem tętniczym mają wyższy wskaźnik masy lewej komory serca oraz przerost lewej komory (LVH). 5 Nadciśnienie tętnicze u dzieci prowadzi również do patologicznych zmian naczyniowych, takich jak zwiększona grubość kompleksu intima-media tętnicy szyjnej. 6

W dużej kohorcie izraelskich rekrutów wojskowych (16-19 lat), nadciśnienie w okresie dojrzewania było związane ze zwiększonym ryzykiem długoterminowej niewydolności nerek, definiowanej na podstawie rejestrów dializ i transplantacji (skorygowany współczynnik ryzyka 1,98, 95% CI 1,42-2,77), chociaż bezwzględne ryzyko było niskie (0,5%). 7 U dzieci z przewlekłą chorobą nerek (PChN), nadciśnienie jest również silnym czynnikiem ryzyka progresji do niewydolności nerek. 8 Nadciśnienie tętnicze jest zdecydowanie związane z progresją PChN u dzieci i dorosłych, a obniżenie ciśnienia krwi zapobiega progresji PChN. 9

Śledzenie nadciśnienia od dzieciństwa do dorosłości

Istnieją silne dowody na to, że nadciśnienie tętnicze w wieku dziecięcym utrzymuje się w wieku dorosłym i jest związane z przedwczesną chorobą układu sercowo-naczyniowego i nerek. 10 Dzieci z większym podwyższeniem ciśnienia krwi mogą być bardziej podatne na rozwój nadciśnienia w wieku dorosłym, ponieważ 80% uczestników z percentylem skurczowego ciśnienia krwi powyżej 90. zarówno w dzieciństwie, jak i w okresie dojrzewania, zgłaszało nadciśnienie w wieku dorosłym. 11

Badania podłużne wykazały, że wysokie ciśnienie krwi w dzieciństwie jest umiarkowanie predykcyjne dla nadciśnienia w wieku dorosłym, które jest znanym czynnikiem ryzyka chorób układu sercowo-naczyniowego (CVD). 12 Ryzyko wystąpienia śmiertelnego/nieprowadzącego do zgonu zdarzenia sercowo-naczyniowego w wieku dorosłym zwiększało się stopniowo wraz ze wzrostem ciśnienia krwi, przy czym zwiększone ryzyko zdarzeń sercowo-naczyniowych u dorosłych zaczynało się już przy wysokim normalnym ciśnieniu krwi (od 50. do 90. percentyla). 13

Wysokie ciśnienie krwi w dzieciństwie było związane z niekorzystnymi zmianami w markerach subklinicznej miażdżycy w wieku dorosłym, takimi jak zwiększona grubość kompleksu intima-media tętnicy szyjnej i zwapnienie tętnic wieńcowych, niezależnie od ciśnienia krwi w wieku dorosłym. 14

Czynniki wpływające na rokowanie

Istnieje szereg czynników, które mogą wpływać na rokowanie u dzieci z nadciśnieniem tętniczym. W jednym z badań zidentyfikowano następujące czynniki związane z podwyższonym ciśnieniem krwi u dzieci:

  • Wiek – uczestnicy w wieku trzech lat i starsi mieli dwukrotnie większe szanse na podwyższone ciśnienie krwi niż osoby w wieku poniżej trzech lat (skorygowany iloraz szans [AOR] 2,46; 95% CI 1,01-5,97) 15
  • Płeć – dziewczynki miały 2,81 razy większe szanse na podwyższone ciśnienie krwi niż chłopcy (AOR 2,81; 95% CI 1,16-6,82) 16
  • Zmniejszony szacunkowy współczynnik filtracji kłębuszkowej – dzieci z obniżonym eGFR miały dwukrotnie większe szanse na podwyższone ciśnienie krwi niż osoby z normalnym eGFR 17

Dzieci i nastolatki z nadciśnieniem tętniczym często mają współistniejące schorzenia metaboliczne. W porównaniu z grupą bez nadciśnienia, dzieci i nastolatki z nadciśnieniem tętniczym były narażone na wyższe ryzyko chorób związanych z zespołem metabolicznym, w tym cukrzycy, hiperlipidemii i otyłości, ze współczynnikami szans wynoszącymi odpowiednio 14,05, 10,65 i 19,08. 1819

Modele predykcyjne i wczesna identyfikacja

Opracowano dynamiczny model predykcyjny dla wysokiego ciśnienia krwi w wieku 9-10 lat, który może być stosowany w dowolnym wieku między urodzeniem a 6. rokiem życia w podstawowej opiece zdrowotnej nad dziećmi. W jednym z badań 227 dzieci (4,2%) miało wysokie ciśnienie krwi w wieku 9-10 lat. 20 Dynamiczny charakter modelu predykcyjnego pozwala na włączenie nowych informacji o wskaźniku SDS BMI, które stają się dostępne w miarę dorastania dziecka, dzięki czemu przewidywane ryzyko może być aktualizowane. 21

Po walidacji wewnętrznej, zdolność dyskryminacyjna modelu predykcyjnego była umiarkowana i najwyższa w wieku 5-6 lat (AUC 0,73), co można wytłumaczyć wyższą wartością predykcyjną wskaźnika SDS BMI w wieku bliższym ocenie wyniku. 22 Model predykcyjny może zatem okazać się pomocny dla specjalistów podstawowej opieki zdrowotnej nad dziećmi, ponieważ pozwoliłby im obiektywnie wybierać dzieci do ukierunkowanej profilaktyki. 23

Znaczenie wczesnego wykrywania i leczenia

Istnieją przekonujące dowody potwierdzające znaczenie wczesnego wykrywania i odpowiedniego leczenia nadciśnienia tętniczego u dzieci. 24 Wczesne wykrywanie i odpowiednie leczenie nadciśnienia o wczesnym początku mają kluczowe znaczenie. 25 Model predykcyjny może pomóc w monitorowaniu ryzyka rozwoju wysokiego ciśnienia krwi w dzieciństwie, co może umożliwić wczesną ukierunkowaną profilaktykę pierwotną chorób układu sercowo-naczyniowego. 26

Pomimo luk w wiedzy, dowody silnie przemawiają za mierzeniem ciśnienia krwi u młodzieży w celu identyfikacji osób z nadciśnieniem. Umożliwi to lekarzom wczesne rozpoczęcie interwencji mających na celu obniżenie ciśnienia krwi, aby zapobiec zmianom w narządach docelowych związanym z incydentami sercowo-naczyniowymi u dorosłych, w celu zmniejszenia światowego obciążenia chorobami układu sercowo-naczyniowego związanymi z ciśnieniem krwi. 27

Cele terapeutyczne i postępowanie

W przypadku dzieci i młodzieży, celem ciśnienia krwi jest wartość poniżej 90. percentyla dla wieku, wzrostu i płci w przypadku pacjentów poniżej 13. roku życia lub poniżej 130/80 mm Hg w przypadku osób w wieku 13 lat i starszych. 28 Dzieci z utrzymującym się podwyższonym ciśnieniem krwi pomimo zastosowania środków niefarmakologicznych, z nadciśnieniem 2. stopnia bez modyfikowalnego czynnika podstawowego lub z współistniejącą cukrzycą lub przewlekłą chorobą nerek powinny zostać poddane ocenie uszkodzeń układu sercowo-naczyniowego za pomocą echokardiografii. 29

Dzieci i młodzież z nadciśnieniem powinny być badane w kierunku hiperlipidemii i podstawowej choroby nerek za pomocą analizy moczu oraz badań poziomu elektrolitów, azotu mocznikowego we krwi i kreatyniny. 30 Dzieci z objawowym nadciśnieniem (np. bóle głowy, zmiany poznawcze), nadciśnieniem 2. stopnia bez modyfikowalnego czynnika, takiego jak otyłość, z dowodami przerostu lewej komory w echokardiografii, lub z jakimkolwiek stopniem nadciśnienia związanym z przewlekłą chorobą nerek lub cukrzycą, lub z utrzymującym się nadciśnieniem pomimo próby modyfikacji stylu życia, wymagają leków przeciwnadciśnieniowych. 31

Wnioski i zalecenia

Nasze wyniki podkreślają znaczenie wczesnego właściwego rozpoznania i odpowiedniego leczenia nadciśnienia, a także chorób związanych z zespołem metabolicznym, wśród dzieci i młodzieży. 32 Uważamy, że te ustalenia mogą zapewnić pracownikom służby zdrowia bardziej kompleksowy wgląd w te kwestie i pomóc w ustanowieniu lepszych polityk badań przesiewowych i terapeutycznych w celu dalszej poprawy zdrowia układu sercowo-naczyniowego przez całe życie. 33

Zalecamy rutynowe sprawdzanie podwyższonego ciśnienia krwi w populacji pediatrycznej, szczególnie u osób ze znanymi czynnikami ryzyka. 34 Nasze badanie sugeruje potrzebę rutynowego pomiaru ciśnienia krwi u dzieci po asfiksji porodowej. Jest to ważne dla wczesnej identyfikacji i terminowego leczenia dzieci z podwyższonym ciśnieniem krwi. 35

Warto zauważyć, że wszystkie trzy specyficzne wytyczne dla pediatrycznego nadciśnienia okazały się znacząco przewidywać ryzyko podwyższonego ciśnienia krwi w wieku dorosłym w wieku 8 lat, 13 lat i 17 lat. 36 Nasze wyniki pokazują niepokojący obraz rosnącej częstości występowania podwyższonego ciśnienia krwi (połączone przednadciśnienie i nadciśnienie) od dzieciństwa do dorosłości, co uzasadnia zwiększenie wysiłków prewencyjnych za pomocą odpowiednich metod i wytycznych wspierających te działania. 37

Wczesne wykrywanie i odpowiednie leczenie nadciśnienia tętniczego u dzieci powinno być priorytetem, aby zapobiec długoterminowym konsekwencjom zdrowotnym zarówno w dzieciństwie, jak i w wieku dorosłym. 38

Kolejne rozdziały

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  1. 16.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    High blood pressure in children and adolescents is a growing health problem that is often overlooked. […] The combined prevalence of elevated blood pressure and hypertension in children is around 6%, or 3% for each. The combined prevalence increases by nearly five times, to around 30%, in adolescents who are obese. […] High blood pressure in childhood is correlated with higher blood pressure and risk of cardiovascular disease (CVD) in adulthood, and this relationship strengthens with age. […] Primary hypertension in children is associated with other risk factors for CVD, including hyperlipidemia and insulin resistance. […] Children also experience target organ damage from hypertension, including left ventricular hypertrophy and pathologic vascular changes (i.e., carotid intima-media thickness).
  • #2 Epidemiology of Hypertension and Cardiovascular Disease in Children and Adolescents | SpringerLink
    https://link.springer.com/10.1007/978-3-319-31420-4_60-1
    Following decades of marked increases in the prevalence of hypertension in children and adolescents, in recent years prevalence rates have stabilized, if not declined. […] Hypertension presenting in adolescence tracks moderately well into adulthood and is a known risk for target organ damage, including left ventricular hypertrophy and subclinical atherosclerosis. […] The prevalence of hypertension in children is estimated to be between 1% and 4%, with rates higher in adolescents as compared to younger children.
  • #3 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    Despite the increasing prevalence and potential risks of hypertension in children, the diagnosis is often overlooked. […] In a cohort of at-risk youth 10 to 18 years of age with comorbid diabetes and obesity, the prevalence of hypertension was 13% using the new guideline, compared with 8% using the old guideline. […] Children with symptomatic hypertension (e.g., headaches, cognitive changes), stage 2 hypertension without a modifiable factor such as obesity, evidence of left ventricular hypertrophy on echocardiography, any stage of hypertension associated with chronic kidney disease or diabetes, or persistent hypertension despite a trial of lifestyle modifications require antihypertensive medications. […] Children and adolescents with hypertension should be screened for hyperlipidemia and underlying renal disease via urinalysis and electrolyte, blood urea nitrogen, and creatinine testing.
  • #4 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. […] Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. […] In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. […] There is strong evidence that pediatric hypertension tracks into adulthood and is associated with premature cardiovascular and kidney diseases. […] Therefore, early detection and adequate management of pediatric hypertension should be prioritized. […] Pediatric hypertension is associated with target organ damage, which in turn is associated with future cardiovascular disease.
  • #5 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Children with hypertension have higher left ventricular mass index and left ventricular hypertrophy (LVH). […] In a large cohort of Israeli military recruits (16-19 years old), adolescent hypertension was associated with an increased risk of long-term kidney failure, as defined by dialysis and transplant registries (adjusted hazard ratio 1.98, 95% CI 1.42-2.77), although the absolute risk was low (0.5%). […] Overall, there is strong evidence that pediatric hypertension is associated with adverse subclinical cardiovascular outcomes. […] Hypertension is strongly associated with CKD progression in children and adults, and BP lowering prevents CKD progression. […] In childhood CKD, hypertension is common (48%-70%), and 50% are adequately controlled.
  • #6 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    High blood pressure in children and adolescents is a growing health problem that is often overlooked. […] The combined prevalence of elevated blood pressure and hypertension in children is around 6%, or 3% for each. The combined prevalence increases by nearly five times, to around 30%, in adolescents who are obese. […] High blood pressure in childhood is correlated with higher blood pressure and risk of cardiovascular disease (CVD) in adulthood, and this relationship strengthens with age. […] Primary hypertension in children is associated with other risk factors for CVD, including hyperlipidemia and insulin resistance. […] Children also experience target organ damage from hypertension, including left ventricular hypertrophy and pathologic vascular changes (i.e., carotid intima-media thickness).
  • #7 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Children with hypertension have higher left ventricular mass index and left ventricular hypertrophy (LVH). […] In a large cohort of Israeli military recruits (16-19 years old), adolescent hypertension was associated with an increased risk of long-term kidney failure, as defined by dialysis and transplant registries (adjusted hazard ratio 1.98, 95% CI 1.42-2.77), although the absolute risk was low (0.5%). […] Overall, there is strong evidence that pediatric hypertension is associated with adverse subclinical cardiovascular outcomes. […] Hypertension is strongly associated with CKD progression in children and adults, and BP lowering prevents CKD progression. […] In childhood CKD, hypertension is common (48%-70%), and 50% are adequately controlled.
  • #8 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. […] Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. […] In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. […] There is strong evidence that pediatric hypertension tracks into adulthood and is associated with premature cardiovascular and kidney diseases. […] Therefore, early detection and adequate management of pediatric hypertension should be prioritized. […] Pediatric hypertension is associated with target organ damage, which in turn is associated with future cardiovascular disease.
  • #9 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Children with hypertension have higher left ventricular mass index and left ventricular hypertrophy (LVH). […] In a large cohort of Israeli military recruits (16-19 years old), adolescent hypertension was associated with an increased risk of long-term kidney failure, as defined by dialysis and transplant registries (adjusted hazard ratio 1.98, 95% CI 1.42-2.77), although the absolute risk was low (0.5%). […] Overall, there is strong evidence that pediatric hypertension is associated with adverse subclinical cardiovascular outcomes. […] Hypertension is strongly associated with CKD progression in children and adults, and BP lowering prevents CKD progression. […] In childhood CKD, hypertension is common (48%-70%), and 50% are adequately controlled.
  • #10 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. […] Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. […] In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. […] There is strong evidence that pediatric hypertension tracks into adulthood and is associated with premature cardiovascular and kidney diseases. […] Therefore, early detection and adequate management of pediatric hypertension should be prioritized. […] Pediatric hypertension is associated with target organ damage, which in turn is associated with future cardiovascular disease.
  • #11 Blood Pressure in Children in the 21st Century: What Do We Know and Where Do We Go From Here?
    https://pmc.ncbi.nlm.nih.gov/articles/PMC10524445/
    The association between hypertension in adulthood and cardiovascular (CV) morbidity and mortality is well known. Based on that association, a diagnosis of elevated blood pressure (BP) in children has been clinically interpreted as early CV disease, and recent studies have now confirmed for the first time a significant association with actual adult CV events. […] Children with greater BP elevation may be more likely to develop adult hypertension as 80% of participants with a systolic BP percentile above 90th% in both childhood and adolescence reported adult hypertension. […] The risk of having a fatal/nonfatal cardiovascular event in adulthood increased in a graded fashion across BP levels, with increased risk of adult cardiovascular events starting for high normal BP (50th to 90th percentile).
  • #12 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Longitudinal studies have demonstrated that childhood high blood pressure is moderately predictive of adulthood hypertension, a well-known risk factor for cardiovascular disease (CVD). […] Such prevention efforts may be targeted to children at high risk of developing high blood pressure. […] We aimed to develop a dynamic prediction model feasible to use in community-based child healthcare, from birth to the age of 6 years, to predict high blood pressure at the age of 910 years. […] The dynamic nature of the prediction model allows for incorporating new information on BMI SDS that becomes available as a child gets older, so that the predicted risk can be updated. […] After internal validation, the discriminative ability of the prediction model was moderate, and highest at the age of 56 years (AUC 0.73) which can be explained by the higher predictive value of BMI SDS at an age closer to the age at outcome assessment.
  • #13 Blood Pressure in Children in the 21st Century: What Do We Know and Where Do We Go From Here?
    https://pmc.ncbi.nlm.nih.gov/articles/PMC10524445/
    The association between hypertension in adulthood and cardiovascular (CV) morbidity and mortality is well known. Based on that association, a diagnosis of elevated blood pressure (BP) in children has been clinically interpreted as early CV disease, and recent studies have now confirmed for the first time a significant association with actual adult CV events. […] Children with greater BP elevation may be more likely to develop adult hypertension as 80% of participants with a systolic BP percentile above 90th% in both childhood and adolescence reported adult hypertension. […] The risk of having a fatal/nonfatal cardiovascular event in adulthood increased in a graded fashion across BP levels, with increased risk of adult cardiovascular events starting for high normal BP (50th to 90th percentile).
  • #14 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Objectives To develop a dynamic prediction model for high blood pressure at the age of 910 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. […] High blood pressure was defined as systolic and/or diastolic blood pressure 95th percentile for gender, age and height. […] 227 children (4.2%) had high blood pressure at the age of 910 years. […] This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease. […] In recent decades, the prevalence of childhood high blood pressure has increased to 4%5%, largely driven by the growing prevalence of childhood overweight and obesity. […] Childhood high blood pressure has been associated with atherosclerosis in autopsy studies, and with unfavourable changes in markers of subclinical atherosclerosis in adulthood, such as increased carotid intima-media thickness and coronary artery calcification, independently of adulthood blood pressure.
  • #15 Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study | Clinical Hypertension | Full Text
    https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00261-6
    The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.636.1)). […] Our findings show a high incidence of elevated blood pressure among children. […] We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors. […] The incidence of elevated blood pressure was 27% (39/140). […] The factors associated with elevated blood pressure were age, sex of the child and a reduced estimated glomerular filtration rate. […] Our study suggests the need to routinely measure blood pressure for children following birth asphyxia. […] This is important for early identification and timely management of children with elevated blood pressure. […] Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (adjusted odds ratio [AOR] 2.46 95%CI (1.015.97).
  • #16 Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study | Clinical Hypertension | Full Text
    https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00261-6
    Female participants had 2.81 times the odds of elevated blood pressure as males (AOR 2.8195% CI (1.166.82). […] Children with reduced estimated glomerular filtration rate had twice the odds of elevated blood pressure as those with normal estimated glomerular filtration rate. […] Our findings show a high incidence of elevated blood pressure among children. This implies that there is an urgent need to investigate the other risk factors of elevated blood pressure in this category.
  • #17 Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study | Clinical Hypertension | Full Text
    https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00261-6
    Female participants had 2.81 times the odds of elevated blood pressure as males (AOR 2.8195% CI (1.166.82). […] Children with reduced estimated glomerular filtration rate had twice the odds of elevated blood pressure as those with normal estimated glomerular filtration rate. […] Our findings show a high incidence of elevated blood pressure among children. This implies that there is an urgent need to investigate the other risk factors of elevated blood pressure in this category.
  • #18 A reappraisal of the prevalence of pediatric hypertension through a nationwide database in Taiwan | Scientific Reports
    https://www.nature.com/articles/s41598-021-84001-6
    Hypertension in childhood and adolescence is associated with adult cardiovascular morbidity and mortality. […] The prevalence of pediatric hypertension in Taiwan ranged from 0.19 to 0.38 per 1000 children and adolescents between 2000 and 2013. […] Children and adolescents with hypertension were often associated with DM, hyperlipidemia, and obesity, with the odds ratios as 14.05, 10.65, and 19.08, respectively. […] To improve lifelong cardiovascular health, our results emphasize the importance of early proper recognition and suitable management of hypertension, as well as metabolic syndrome-related diseases, among children and adolescents. […] The prevalence of pediatric hypertension in Taiwan ranged from 0.19 to 0.38 per 1000 children and adolescents and it was increasing gradually during the entire study period.
  • #19 A reappraisal of the prevalence of pediatric hypertension through a nationwide database in Taiwan | Scientific Reports
    https://www.nature.com/articles/s41598-021-84001-6
    In comparison to the non-hypertension group, children and adolescents with hypertension were found to be at higher risks for metabolic syndrome-related diseases, including DM, hyperlipidemia, and obesity. […] Although the prevalence of pediatric hypertension was not high in Taiwan, the present study did reveal the medical claims by the physicians; additionally, it may also reflect the current state of healthcare providers’ awareness of these issues. […] The present study still offers a useful summary of hypertension and metabolic syndrome-related diseases among children and adolescents in Taiwan using our national health database. […] We believe these findings can offer healthcare providers more-comprehensive insights into these issues and help establish better screening and therapeutic policies to further improve lifelong cardiovascular health.
  • #20 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Objectives To develop a dynamic prediction model for high blood pressure at the age of 910 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. […] High blood pressure was defined as systolic and/or diastolic blood pressure 95th percentile for gender, age and height. […] 227 children (4.2%) had high blood pressure at the age of 910 years. […] This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease. […] In recent decades, the prevalence of childhood high blood pressure has increased to 4%5%, largely driven by the growing prevalence of childhood overweight and obesity. […] Childhood high blood pressure has been associated with atherosclerosis in autopsy studies, and with unfavourable changes in markers of subclinical atherosclerosis in adulthood, such as increased carotid intima-media thickness and coronary artery calcification, independently of adulthood blood pressure.
  • #21 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Longitudinal studies have demonstrated that childhood high blood pressure is moderately predictive of adulthood hypertension, a well-known risk factor for cardiovascular disease (CVD). […] Such prevention efforts may be targeted to children at high risk of developing high blood pressure. […] We aimed to develop a dynamic prediction model feasible to use in community-based child healthcare, from birth to the age of 6 years, to predict high blood pressure at the age of 910 years. […] The dynamic nature of the prediction model allows for incorporating new information on BMI SDS that becomes available as a child gets older, so that the predicted risk can be updated. […] After internal validation, the discriminative ability of the prediction model was moderate, and highest at the age of 56 years (AUC 0.73) which can be explained by the higher predictive value of BMI SDS at an age closer to the age at outcome assessment.
  • #22 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Longitudinal studies have demonstrated that childhood high blood pressure is moderately predictive of adulthood hypertension, a well-known risk factor for cardiovascular disease (CVD). […] Such prevention efforts may be targeted to children at high risk of developing high blood pressure. […] We aimed to develop a dynamic prediction model feasible to use in community-based child healthcare, from birth to the age of 6 years, to predict high blood pressure at the age of 910 years. […] The dynamic nature of the prediction model allows for incorporating new information on BMI SDS that becomes available as a child gets older, so that the predicted risk can be updated. […] After internal validation, the discriminative ability of the prediction model was moderate, and highest at the age of 56 years (AUC 0.73) which can be explained by the higher predictive value of BMI SDS at an age closer to the age at outcome assessment.
  • #23 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    The prediction model might therefore prove helpful to community-based child healthcare professionals, because it would allow them to objectively select children for targeted prevention. […] This study has several strengths and limitations. […] It should be noted that we could only measure the outcome as high blood pressure and not as hypertension. […] Therefore, extra attention to these children could still be warranted, although we must be aware that this has not yet been studied for the more recent reference values for high blood pressure based on non-overweight populations. […] In summary, we developed a dynamic prediction model to predict the development of childhood high blood pressure based on information that is usually recorded or is easy to obtain in community-based child healthcare practice.
  • #24 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. […] Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. […] In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. […] There is strong evidence that pediatric hypertension tracks into adulthood and is associated with premature cardiovascular and kidney diseases. […] Therefore, early detection and adequate management of pediatric hypertension should be prioritized. […] Pediatric hypertension is associated with target organ damage, which in turn is associated with future cardiovascular disease.
  • #25 A comparison of paediatric hypertension clinical practice guidelines and their ability to predict adult hypertension in an African birth cohort | Journal of Human Hypertension
    https://www.nature.com/articles/s41371-022-00709-6
    Thus, the identification and treatment of early onset hypertension are paramount. […] Our findings must be interpreted within the context of the strengths, limitations, and recommendations of this study. […] In conclusion, our results showed a concerning picture of rising elevated BP (combined pre-hypertension and hypertension) prevalence from childhood into adulthood, which warrants more prevention efforts to be upscaled with appropriate methods and guidelines to support this. […] All three specific paediatric CPG were found to significantly predict the risk of elevated BP in adulthood at ages 8years, 13years and 17years respectively.
  • #26 Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study | BMJ Open
    https://bmjopen.bmj.com/content/8/11/e023912
    Objectives To develop a dynamic prediction model for high blood pressure at the age of 910 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. […] High blood pressure was defined as systolic and/or diastolic blood pressure 95th percentile for gender, age and height. […] 227 children (4.2%) had high blood pressure at the age of 910 years. […] This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease. […] In recent decades, the prevalence of childhood high blood pressure has increased to 4%5%, largely driven by the growing prevalence of childhood overweight and obesity. […] Childhood high blood pressure has been associated with atherosclerosis in autopsy studies, and with unfavourable changes in markers of subclinical atherosclerosis in adulthood, such as increased carotid intima-media thickness and coronary artery calcification, independently of adulthood blood pressure.
  • #27 Blood Pressure in Children in the 21st Century: What Do We Know and Where Do We Go From Here?
    https://pmc.ncbi.nlm.nih.gov/articles/PMC10524445/
    Although there are still gaps in knowledge, the evidence makes a strong case for measuring BP in youth, in order to identify those with hypertension. This will allow practitioners to initiate interventions to reduce BP early to prevent target organ changes linked to adult CV events with the goal of reducing the worldwide burden of BP-related CV disease.
  • #28 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    Following the diagnosis of elevated blood pressure or hypertension, a careful history and physical examination can help determine if the child has primary or secondary hypertension. […] Children with persistently elevated blood pressure despite nonpharmacologic measures, stage 2 hypertension without a modifiable underlying factor, or comorbid diabetes or chronic kidney disease should be evaluated for cardiovascular damage with echocardiography. […] For children and adolescents, the blood pressure goal is less than the 90th percentile for age, height, and sex for patients younger than 13 years, or less than 130/80 mm Hg for those 13 years and older.
  • #29 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    Following the diagnosis of elevated blood pressure or hypertension, a careful history and physical examination can help determine if the child has primary or secondary hypertension. […] Children with persistently elevated blood pressure despite nonpharmacologic measures, stage 2 hypertension without a modifiable underlying factor, or comorbid diabetes or chronic kidney disease should be evaluated for cardiovascular damage with echocardiography. […] For children and adolescents, the blood pressure goal is less than the 90th percentile for age, height, and sex for patients younger than 13 years, or less than 130/80 mm Hg for those 13 years and older.
  • #30 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    Despite the increasing prevalence and potential risks of hypertension in children, the diagnosis is often overlooked. […] In a cohort of at-risk youth 10 to 18 years of age with comorbid diabetes and obesity, the prevalence of hypertension was 13% using the new guideline, compared with 8% using the old guideline. […] Children with symptomatic hypertension (e.g., headaches, cognitive changes), stage 2 hypertension without a modifiable factor such as obesity, evidence of left ventricular hypertrophy on echocardiography, any stage of hypertension associated with chronic kidney disease or diabetes, or persistent hypertension despite a trial of lifestyle modifications require antihypertensive medications. […] Children and adolescents with hypertension should be screened for hyperlipidemia and underlying renal disease via urinalysis and electrolyte, blood urea nitrogen, and creatinine testing.
  • #31 High Blood Pressure in Children and Adolescents | AAFP
    https://www.aafp.org/pubs/afp/issues/2018/1015/p486.html
    Despite the increasing prevalence and potential risks of hypertension in children, the diagnosis is often overlooked. […] In a cohort of at-risk youth 10 to 18 years of age with comorbid diabetes and obesity, the prevalence of hypertension was 13% using the new guideline, compared with 8% using the old guideline. […] Children with symptomatic hypertension (e.g., headaches, cognitive changes), stage 2 hypertension without a modifiable factor such as obesity, evidence of left ventricular hypertrophy on echocardiography, any stage of hypertension associated with chronic kidney disease or diabetes, or persistent hypertension despite a trial of lifestyle modifications require antihypertensive medications. […] Children and adolescents with hypertension should be screened for hyperlipidemia and underlying renal disease via urinalysis and electrolyte, blood urea nitrogen, and creatinine testing.
  • #32 A reappraisal of the prevalence of pediatric hypertension through a nationwide database in Taiwan | Scientific Reports
    https://www.nature.com/articles/s41598-021-84001-6
    Hypertension in childhood and adolescence is associated with adult cardiovascular morbidity and mortality. […] The prevalence of pediatric hypertension in Taiwan ranged from 0.19 to 0.38 per 1000 children and adolescents between 2000 and 2013. […] Children and adolescents with hypertension were often associated with DM, hyperlipidemia, and obesity, with the odds ratios as 14.05, 10.65, and 19.08, respectively. […] To improve lifelong cardiovascular health, our results emphasize the importance of early proper recognition and suitable management of hypertension, as well as metabolic syndrome-related diseases, among children and adolescents. […] The prevalence of pediatric hypertension in Taiwan ranged from 0.19 to 0.38 per 1000 children and adolescents and it was increasing gradually during the entire study period.
  • #33 A reappraisal of the prevalence of pediatric hypertension through a nationwide database in Taiwan | Scientific Reports
    https://www.nature.com/articles/s41598-021-84001-6
    In comparison to the non-hypertension group, children and adolescents with hypertension were found to be at higher risks for metabolic syndrome-related diseases, including DM, hyperlipidemia, and obesity. […] Although the prevalence of pediatric hypertension was not high in Taiwan, the present study did reveal the medical claims by the physicians; additionally, it may also reflect the current state of healthcare providers’ awareness of these issues. […] The present study still offers a useful summary of hypertension and metabolic syndrome-related diseases among children and adolescents in Taiwan using our national health database. […] We believe these findings can offer healthcare providers more-comprehensive insights into these issues and help establish better screening and therapeutic policies to further improve lifelong cardiovascular health.
  • #34 Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study | Clinical Hypertension | Full Text
    https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00261-6
    The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.636.1)). […] Our findings show a high incidence of elevated blood pressure among children. […] We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors. […] The incidence of elevated blood pressure was 27% (39/140). […] The factors associated with elevated blood pressure were age, sex of the child and a reduced estimated glomerular filtration rate. […] Our study suggests the need to routinely measure blood pressure for children following birth asphyxia. […] This is important for early identification and timely management of children with elevated blood pressure. […] Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (adjusted odds ratio [AOR] 2.46 95%CI (1.015.97).
  • #35 Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study | Clinical Hypertension | Full Text
    https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00261-6
    The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.636.1)). […] Our findings show a high incidence of elevated blood pressure among children. […] We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors. […] The incidence of elevated blood pressure was 27% (39/140). […] The factors associated with elevated blood pressure were age, sex of the child and a reduced estimated glomerular filtration rate. […] Our study suggests the need to routinely measure blood pressure for children following birth asphyxia. […] This is important for early identification and timely management of children with elevated blood pressure. […] Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (adjusted odds ratio [AOR] 2.46 95%CI (1.015.97).
  • #36 A comparison of paediatric hypertension clinical practice guidelines and their ability to predict adult hypertension in an African birth cohort | Journal of Human Hypertension
    https://www.nature.com/articles/s41371-022-00709-6
    Thus, the identification and treatment of early onset hypertension are paramount. […] Our findings must be interpreted within the context of the strengths, limitations, and recommendations of this study. […] In conclusion, our results showed a concerning picture of rising elevated BP (combined pre-hypertension and hypertension) prevalence from childhood into adulthood, which warrants more prevention efforts to be upscaled with appropriate methods and guidelines to support this. […] All three specific paediatric CPG were found to significantly predict the risk of elevated BP in adulthood at ages 8years, 13years and 17years respectively.
  • #37 A comparison of paediatric hypertension clinical practice guidelines and their ability to predict adult hypertension in an African birth cohort | Journal of Human Hypertension
    https://www.nature.com/articles/s41371-022-00709-6
    Thus, the identification and treatment of early onset hypertension are paramount. […] Our findings must be interpreted within the context of the strengths, limitations, and recommendations of this study. […] In conclusion, our results showed a concerning picture of rising elevated BP (combined pre-hypertension and hypertension) prevalence from childhood into adulthood, which warrants more prevention efforts to be upscaled with appropriate methods and guidelines to support this. […] All three specific paediatric CPG were found to significantly predict the risk of elevated BP in adulthood at ages 8years, 13years and 17years respectively.
  • #38 High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9091586/
    Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. […] Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. […] In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. […] There is strong evidence that pediatric hypertension tracks into adulthood and is associated with premature cardiovascular and kidney diseases. […] Therefore, early detection and adequate management of pediatric hypertension should be prioritized. […] Pediatric hypertension is associated with target organ damage, which in turn is associated with future cardiovascular disease.

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