Primary hypertension is a disease of premature vascular aging associated with neuro-immuno-metabolic abnormalities.
There is an increasing amount of data indicating that primary hypertension (PH) is not only a hemodynamic phenomenon but also a complex syndrome involving abnormal fat tissue distribution, over-activity of the sympathetic nervous system (SNS), metabolic abnormalities, and activation of the immune system. In children, PH usually presents with a typical phenotype of disturbed body composition, accelerated biological maturity, and subtle immunological and metabolic abnormalities. This stage of the disease is potentially reversible. However, long-lasting over-activity of the SNS and immuno-metabolic alterations usually lead to an irreversible stage of cardiovascular disease. We describe an intermediate phenotype of children with PH, showing that PH is associated with accelerated development, i.e., early premature aging of the immune, metabolic, and vascular systems. The associations and determinants of hypertensive organ damage, the principles of treatment, and the possibility of rejuvenation of the cardiovascular system are discussed.
Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland. m.litwin@ipczd.pl.
Mieczysław
M
Litwin
Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.
Janusz
J
Feber
Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland.
Anna
A
Niemirska
Department of Microbiology and Immunology, The Children's Memorial Health Institute, Warsaw, Poland.|Department of Immunology, Medical University, Bydgoszcz, Poland.
Jacek
J
Michałkiewicz
D019588:Aging, Premature / Q000150:complications / Q000503:physiopathology*; D001823:Body Composition; D002648:Child; D000075222:Essential Hypertension; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000276:immunology / Q000503:physiopathology*; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications; D013564:Sympathetic Nervous System / Q000503:physiopathology
Children; Immunologic activity; Metabolic syndrome; Primary hypertension; Sympathetic activity; Target organ damage; Vascular aging