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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.

    Conditions Under Which Children <3 Years Old Should Have BP Measured

    – 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

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