[Systemic arterial hypertension in child and adolescent].
The epidemic of childhood obesity, the risk of developing left ventricular hypertrophy, and evidence of the early development of atherosclerosis in children would make the detection of and intervention in childhood hypertension important to reduce long-term health risks; however, supporting data are lacking. Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including obesity and a family history of hypertension. Evaluation involves a through history and physical examination, laboratory tests, and specialized studies. Management is multifaceted. Nonpharmacologic treatments include weight reduction, exercise, and dietary modifications. Although the evidence of first line therapy for hypertension is still controversial, the recommendations for pharmacologic treatment are based on symptomatic hypertension, evidence of end-organ damage, stage 2 of hypertension, or stage 1 of hypertension unresponsive to lifestyle modifications, and hypertension with diabetes mellitus where is the search for microalbuminuria justified.
División de Investigación en Salud, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. mrosas_peralta@hotmail.com.
Martín
M
Rosas-Peralta
Luz Elena
LE
Medina-Concebida
Gabriela
G
Borrayo-Sánchez
Alejandra
A
Madrid-Miller
Erick
E
Ramírez-Arias
Gilberto
G
Pérez-Rodríguez
D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000379:methods; D002648:Child; D003131:Combined Modality Therapy; D004035:Diet Therapy; D005081:Exercise Therapy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008800:Mexico / Q000453:epidemiology; D010808:Physical Examination; D012307:Risk Factors
D000959:Antihypertensive Agents
Adolescent; Child; Hypertension; Obesity; Treatment