Missed Hypertension in Adolescents & Risk of ESRD
Persistent hypertension in adulthood is a leading cause of end-stage renal disease (ESRD). Whether lower blood pressure (BP) values, in the range of prehypertension, are also associated with future occurrence of ESRD is unclear. A recent study published in Journal of Hypertension clearly shows that asymptomatic, healthy adolescents with prehypertension have a 32% increased risk for subsequent ESRD, compared with adolescents with optimal BP.
The fourth report clearly shows that the long-term health risks for hypertensive children and adolescents can be substantial; therefore, it is important that clinical measures be taken to reduce these risks and optimize health outcomes.
MEASUREMENT OF BP IN CHILDREN
Children >3 years old who are seen in a medical setting should have their BP measured.
The preferred method of BP measurement is auscultation.
– History of prematurity, very low birth weight, or other neonatal complication requiring intensive care – Congenital heart disease (repaired or nonrepaired) – Recurrent urinary tract infections, hematuria, or proteinuria – Known renal disease or urologic malformations – Family history of congenital renal disease – Solid-organ transplant – Malignancy or bone marrow transplant – Treatment with drugs known to raise BP – Other systemic illnesses associated with hypertension (neurofibromatosis, tuberous sclerosis, etc) – Evidence of elevated intracranial pressure