title: Pathophysiology of hypertension in obese children: a systematic review.
abstract: Hypertension is increasingly common in overweight and obese children. The mechanisms behind the development of hypertension in obesity are complex, and evidence is limited. In order to effectively treat obese children for hypertension, it is important to have a deeper understanding of the pathophysiology of hypertension in obese children. The present review summarizes the main factors associated with hypertension in obese children and discusses their potential role in its pathophysiology. Systematic searches were conducted in PubMed and EMBASE for articles published up to October 2014. In total, 60 relevant studies were included. The methodological quality of the included studies ranged from weak to strong. Several factors important in the development of hypertension in obese children have been suggested, including endocrine determinants, such as corticosteroids and adipokines, sympathetic nervous system activity, disturbed sodium homeostasis, as well as oxidative stress, inflammation and endothelial dysfunction. Understanding the pathophysiology of hypertension in overweight and obese children is important and could have implications for its screening and treatment. Based on solely cross-sectional observational studies, it is impossible to infer causality. Longitudinal studies of high methodological quality are needed to gain more insight into the complex mechanisms behind the development of hypertension in obese children.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: A J G
authors.initials: AJ
authors.lastname: Wirix
authors.affiliation: Medical Library, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Kaspers
authors.affiliation: Department of Pediatric Nephrology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Nauta
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M J M
authors.initials: MJ
authors.lastname: Chinapaw
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Kist-van Holthe
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D007333:Insulin Resistance; D018384:Oxidative Stress; D063766:Pediatric Obesity / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D054392:Adipokines
keywords: Children; hypertension; obesity; pathophysiology