Pediatric Hypertension

The field of pediatric hypertension has undergone important changes in the time since the second edition of Pediatric Hypertension published. Much new information on hypertension in the young has become available. Previous chapters have been fully revised and new chapters have been added to cover important topics of recent interest such as consensus recommendations, the prevalence of hypertension in the young due to the obesity epidemic, studies of antihypertensive agents, and ambulatory blood pressure monitoring. Pediatric Hypertension, Third Edition is a comprehensive volume featuring 38 chapters covering the breadth of the current knowledge. It is divided into four sections: Regulation of Blood Pressure in Children; Assessment of Blood Pressure in Children: Measurement, Normative Data, Epidemiology; and Hypertension in Children: Predictors, Risk Factors, and Special Populations; Evaluation and Management of Pediatric Hypertension. Filled with the most up-to-date information, Pediatric Hypertension, Third Edition is an invaluable resource for clinicians and researchers interested in childhood hypertension.

This book is devoted to hypertension in children and adolescents, a clinical issue that – thanks to the strides made in several areas of pathophysiological and clinical research – has received growing interest in cardiovascular medicine over the last several years. Given the increasing prevalence of hypertension in children and adolescents, this book represents an important and useful tool to address what has become a significant public health issue. It covers a diverse range of topics, from advances in the definition of hypertension and the identification of new risk factors, to current treatment strategies. The book also presents an overview of the latest findings, including the clinical significance of isolated systolic hypertension (ISH) in youth, the importance of out-of-office and central blood pressure measurement, new methods for assessing vascular phenotypes, and clustering of CV risk factors. Gathering contributions by international experts and pursuing a practice-oriented approach, the book offers a valuable tool for cardiologists, pediatricians and nephrologists, as well as general practitioners.

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The importance of hypertension in children and adolescents is becoming incre- ingly recognized by physicians and scientists in the 21st century. However, in contrast to the attention that hypertension has received in the adult population for the past three decades since the first Joint National Committee (JNC) report, research and clinical knowledge that involves hypertension in children is still very much in its own childhood. Pediatric Hypertension, edited by Drs. Portman, Sorof, and Ingelfinger, is undoubtedly the most up-to-date and clinically relevant contribution to the field of hypertension in children available because it brings together the numerous pathophysiologic, diagnostic, and therapeutic advances in the evaluation of high blood pressure in infants, children, and adolescents. The editors have carefully organized their volume into sections that cover blood pressure regulation in infants and children, blood pressure measurement issues, pat- physiology and clinical assessment for essential and secondary forms of hypertension during childhood, and nonpharmacologic and pharmacologic approaches to the tre- ment of hypertension in children.

For the past 17 years, Pediatric Hypertension has served as the definitive reference text on hypertension in children and adolescents. Each edition has incorporated the latest research on the pathophysiology, clinical significance and management of hypertension in the young, and has incorporated the most current consensus guidelines on diagnosis and management. The years since publication of the fourth edition have seen further advances in the field that merit publication of an updated, expanded text, including: Analysis of the implications of updated hypertension guidelines on identification of youth at highest cardiovascular risk Additional data on the proximate effects of high blood pressure in children in adolescents Further understanding of the links between high blood pressure in youth and surrogate markers of adult cardiovascular disease The fifth edition is a readable, informative text that provides a comprehensive guide to the diagnosis, management and therapy of hypertension in children and adolescents, and presents new data that very clearly indicate that the origins of adult cardiovascular disease are rooted in pediatric hypertension. It will, as a result, be very important for therapeutic decisions and will also be highly relevant for those in internal medicine, who care for the millions of adults who have hypertension, cardiovascular disease and kidney disease. In this sense, the book fulfills the longstanding goal of showing that hypertension that begins in childhood is important to track, diagnose and treat, and that the present understanding of adult hypertension necessitates the study of blood pressure in youth. The fifth edition has a similar structural format to the prior editions and covers all aspects of pediatric hypertension, from basic science research to the most recent clinical information.

Essential hypertension is quite rare in childhood or adolescence. A secondary cause behind the raised blood pressure should therefore be searched, e.g. renal disease, aortic coarcation, endocrine causes, raised intracranial pressure etc. Blood pressure medication should not be commenced before aetiological examinations have been conducted in specialist care. Further examinations conducted by a specialist are needed if the blood pressure values measured in a child exceed the 95th percentile values repeatedly (table ).

Hypertension and its resultant complications do occur in childhood and track into adulthood. It's estimated that > 3% of all children have hypertension, with an even greater prevalence among obese children (20-47%). The etiology of hypertension is generally described as primary (essential) or secondary with most secondary causes related to cardio-renal disease. While primary hypertension is on the rise, all children should undergo an evaluation to investigate for a secondary cause of their hypertension. Mild to moderate hypertension is most commonly asymptomatic but may be associated with subtle cardiac, renal, neurological and/or psychosocial.