Hypertension in childhood and adolescence

Hypertension is noted less frequently in children than in adults, with a prevalence of approximately 3%. However, hypertensive children and adolescents may already present early signs of cardiovascular end organ damage. As the blood pressure level tracks into adult life, hypertensive children are likely to become hypertensive adults at risk for early cardiovascular morbidity and mortality. One major risk factor for primary hypertension is obesity; the global trend towards pediatric obesity is likely to increase the risk of essential hypertension in childhood and adolescence. In infants and younger children hypertension is usually secondary, most commonly due to renal diseases. Therefore, hypertensive children should undergo thorough diagnostic procedures to rule out secondary forms of hypertension. As hypertension is usually asymptomatic, standardized blood pressure measurements should be routinely performed in infants with an increased risk of hypertension and in all children starting from 3 years of age. Blood pressure should be referenced to normal ranges for age, height and gender. © 2011 Springer-Verlag.