Primary care management of childhood and adolescent hypertension.
OBJECTIVE
To educate advance practice nurses on the diagnosis, pharmacologic, and nonpharmacologic management of hypertension in children and adolescents.


METHODS
Information was collected through a search of published literature and clinical practice guidelines.


CONCLUSIONS
Increasing rates of hypertension in children and adolescents are correlated to risk for coronary artery disease in adulthood. Nonpharmacologic management includes lifestyle modifications addressing weight reduction, physical activity, and dietary modification. Pharmacologic management is typically reserved for patients with severe hypertension or those who do not respond to lifestyle modifications. Early intervention is critical for preventing target-organ damage and complications of long-term hypertension.


CONCLUSIONS
Nurse practitioners must identify and address elevated blood pressure levels in children and adolescents. Many children and adolescents can successfully lower blood pressure readings through nonpharmacologic lifestyle changes. Education about lifestyle modification strategies should focus on family-based changes in order to increase likelihood of successful implementation.
Anglum
Abigail
A
Cleveland Clinic, Cleveland, Ohio, USA. angluma@ccf.org
D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D008019:Life Style; D009722:Nurse Practitioners; D010353:Patient Education as Topic; D012016:Reference Values
D000959:Antihypertensive Agents