The referral centers for the diagnosis and treatment of hypertension in adolescents

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Primary hypertension in adolescence was felt to be quiterare. However, the worldwide childhood obesity epidemichas had a profound impact on the frequency ofhigh blood pressure (BP) with the result that primaryhypertension should now be viewed as one of the mostcommon health conditions in the young (estimated prevalence1–5%).Therefore, current guidelines recommend that all childrenand adolescents seen in a medical setting shouldhave their BP measured. The availability of BP tableswith normal BP percentiles for age, sex and height hasimproved BP values classification.Studies conducted at referral clinics for evaluation ofhypertension have indicated that as many as 30 to 40%of adolescents may actually have in a clinical settingwhite-coat hypertension. This may lead to a misdiagnosisof “true” hypertension in a considerable number ofcases. The usefulness of out-of-office BP evaluationusing ambulatory or home monitoring is well established.These measurements allow the detection of thewhite-coat and masked hypertension, the opposite ofwhite-coat hypertension, and are more closely associatedwith organ damage and cardiovascular risk than officemeasurements. A thorough familial and personal historyis of primary importance as well as the physical examinationthat should be focused on the search for signssuggestive for an underlying cause and/or for the severityof hypertension.Following investigations must be tailored to the child’sage, anamnesis and clinical examination and to theseverity of BP elevation, in order to investigate not onlythe possible cause of hypertension, but also associated diseases and target organs damage. Therapeuticapproach should firstly include non-pharmacologicalmeasures, and the use of medications when indicated.A key role in the management of the adolescents withhypertension may be attributed to the hypertensionreferral centers
Lingua originaleEnglish
Numero di pagine1
Stato di pubblicazionePublished - 2015


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