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Consensus Developed on Managing Hypertension in Children

Differing positions of current guidelines make the definition and management of arterial hypertension in children and adolescents uncertain

THURSDAY, Aug. 18, 2022 (HealthDay News) — In a consensus document published online July 27 in the European Heart Journal, recommendations are presented for the management of hypertension among children aged 6 to 16 years.

On behalf of the ESC Council on Hypertension, European Association of Preventive Cardiology, European Association of Cardiovascular Imaging, Association of Cardiovascular Nursing & Allied Professions, ESC Council for Cardiology Practice, and Association for European Paediatric and Congenital Cardiology, Giovanni de Simone, M.D., from the Federico II University of Naples in Italy, and colleagues reviewed the literature and evidence to produce a consensus document focusing on hypertension in children and adolescents.

The authors recommend implementing the development of appropriate multiethnic normative tables for office blood pressure, ambulatory blood pressure, and home blood pressure measurements through the organization of longitudinal registries, with the potential to link to adult cardiovascular risk. They also recommend the development of randomized clinical trials to document the specific benefits and potential harms of blood pressure-lowering agents and behavioral lifestyle strategies. Hypertension management should include a stepped approach for management, starting with lifestyle modifications, followed by a low-dose single drug, full-dose single drug or low-dose combination, and full-dose combination, as appropriate.

“Parents are significant agents of change in the promotion of children’s health behaviors,” de Simone said in a statement. “Very often, high blood pressure and/or obesity coexist in the same family. But even when this is not the case, it is desirable that lifestyle modifications involve all family members.”

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