Hypertension in Children

The importance of hypertension lies in the fact that it represents one of the most significant risk factors for the development of atherosclerotic cardiovascular disease, which is still the main cause of mortality in developed countries as well as in some parts of underdeveloped world. Since essential hypertension has its roots in childhood, its prevention, diagnosis, monitoring and treatment also need to be initiated in children and adolescents. This paper defines hypertension in children somewhat differently from adult hypertension and the prevalence of high blood pressure is much lower in childhood than in the adult age. In young children, more detailed examination and testing are needed to determine the etiology of hypertension. In adolescents and adults, on the other hand, essential hypertension is suspected sooner and additional diagnostics is performed only in the case of resistance to therapy. In young children, hypertension is most often secondary. Assessment of the level of target organ damage (heart, blood vessels, kidneys) in children, which through different stages leads to the development of atherosclerotic cardiovascular disease, is also of special importance. Pharmacological treatment of pediatric patients is based on rare studies, experience of individual centres and daily clinical practice, and it is also supported by the study of pediatric dosages with respect to adult data. It is not only the objective of health care services to prevent and diagnose hypertension, but also of the state and civil society. In 2009, the European Society for Hypertension issued special recommendations for the treatment of hypertension in children. We are trying to adopt these recommendations in Slovenia as well, and they have also served as the basis for this paper.