Short CommunicationShort Communication
The vision of hypertension (HT) in children has varied in recent years, based on the knowledge that hypertension in adults has its origins in childhood [1]. HTA in children has been underestimated by some medical professionals, many consider it an adult disease, and others recognize its onset in adolescence [2]. Obesity, considered the epidemic of the 21st century, is also present in childhood, and has contributed to the increase in hypertension in children and adolescents, and to the existence of the metabolic syndrome, which accelerates atherosclerosis and increases the possibility of organ involvement. Diana. Obesity, combined with other factors, such as low birth weight, can significantly increase the risk of developing HT [3]. It is well recognized that HT is a cardiovascular risk factor, and that in adulthood it contributes to morbidity and mortality from myocardial infarction, stroke, congestive heart failure, peripheral vascular disease, retinopathy, and end-stage renal disease, so It has been recognized the need to take blood pressure at least once a year from 3 years of age, and to act early on the risk factors for cardiovascular disease, both in the child and in their family members [4]. The measurement of Blood pressure would help the diagnosis and early treatment of asymptomatic hypertensive children and adolescents, before complications or repercussions in the target organs occur [5].
It is important to note that the primary health care physician
plays an important role in the primary prevention of the disease,
acting on the risk factors that the infant presents. Currently, the
diagnosis of hypertension in children presents important problems,
because there is not an adequate perception of risk about the
disease by some professionals, just as there are very few children
who are dispensed as hypertensive, and finally, the recording of
blood pressure is not part of the pediatric physical examination.
HTA is a multifactorial disease, interrelated with environmental
factors, which has been increasing with new inadequate lifestyles,
sedentary life and eating habits, which tend to fast foods and foods
classified as “junk”, of little nutritional value, with excess salt, fat
and sugars [6]. High blood pressure is not a very frequent problem
in pediatrics, compared to adulthood, however, when it occurs,
the consequences can be very serious [7]. High blood pressure
(hypertension) in pediatric age has increased in recent years due to
the increase in overweight and obesity. An approximate prevalence
of 3 to 5% is estimated in the United States of America, which
may be higher in certain ethnic groups such as African Americans,
Mexicans, and Hispanics. Some isolated geographic areas have
reported up to 10%, and in the obese it can reach up to 11% [1-5].
Years ago, secondary HT was considered to be the most
frequent form of presentation in children, but there is currently the criterion that essential or primary HT occurs more frequently
in pediatric ages, partly due to the increase in obesity in epidemic
proportions, as well as inadequate lifestyles [8]. The cornerstone
in the treatment of HT is non-pharmacological treatment, or
modification of lifestyles, which even when the patient needs
drug treatment, can never abandon [9]. Taking blood pressure in
the pediatric outpatient clinic is a simple, non-invasive and quick
procedure, it must have the equipment in good condition and
the ideal size sphygmomanometer cuff, to carry out an adequate
measurement and in the best conditions to avoid confusions [10].
The most important thing in childhood HT is its prevention, and
childhood is the ideal time for it. The doctor must be aware of the
disease and therefore must take the pressure systematically as part
of the pediatric physical examination. It is necessary to eliminate
the underreporting of the disease in order to treat it in a timely
manner and thus avoid complications in adulthood.
References
- Lurbe E, Álvarez J, Redon J (2010) Diagnosis and Treatment of Hypertension in Children. CurrHypertens Rep 12(6): 480-486.
- Mc Crindle BW (2010) Assessment and management of hypertension in children andadolescents. Nature Reviews Cardiology 7(3): 155-163.
- Feber J, Maheen A (2010) Hypertension in children: new trends and challenges. Clinical Science 119(4): 151-161.
- (2004) National High Blood Pressure Education Program Working Group on High BloodPressure un Children and Adolescent. The Fourth Report on the diagnosis,evaluation, and treatment of High Blood Pressure in Children and Adolescents.Pediatrics 114(2): 555-576.
- Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, et al. (2010) Manejode la hipertensión arterial en niños y adolescentes: recomendaciones de laSociedad Europea de Hipertensió AnPediatr (Barc) 73(1): 51.e1-51.e28.
- Llapur R, González R (2008) Hipertensión arterial y grupos especiales. Guía para la prevención, diagnóstico y tratamiento de la hipertensión arterial. Comisión Nacional Técnico Asesora del Programa de Hipertensión Arterial [libro en Internet]. La Habana: Editorial de Ciencias Mé
- González Sánchez R, Llapur Milián R, Jiménez Hernández JM, Sánchez Pompa A (2012) Percepción de los médicos de atención primaria de salud sobre el riesgo dehipertensión arterial en la infancia. Rev Cubana Pediatr 84(2): 155-164.
- Busaniche J, Eymann A, Otero P, L lera J (2008) Análisis de registros de tensión arterial en pacientes de 3-20 años por pediatras en la historia clínica electró Arch Argent Pediatric 106(3): 226-230.
- Lazarou C, Panagiotakos DB, Matalas AL (2009) Lifestyle factors are determinants of childrens blood pressure levels: CYKIDS study. Journal of Human Hypertension 23: 456-463.
- Falkner B (2010) Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol 25(7): 1219-1224.
