Concepts guiding therapy for hypertension in children

Abstract

Increasing attention has been focused on identifying children with prehypertension and hypertension (HTN). Obesity and low birthweight are two risk factors that predispose children to develop HTN during their childhood years or later as adults. Early onset of pre-HTN and HTN increases the lifetime risk for cardiovascular sequelae. Lifestyle modification should be part of the initial recommendations for management of all hypertensive children. In those children requiring pharmacologic therapy, the choice of medication should be guided by the etiology of HTN, the needs of the child and the risk and benefit profiles of the various drug classes. The long-term impact of antihypertensive therapy in children is not known. Concerns regarding the effects of HTN and its treatment on cognitive function are of particular importance in the growing child and warrant further study. Ongoing investigations that offer promise for innovative therapeutic approaches in the future are discussed.