Pediatria pre prax 2/2013

Diagnostics of hypertension in childhood

The number of patients presenting to the pediatric clinic with suspected hypertension is still increasing. The causes of hypertension may include severe disorders of the heart, vascular, renal or endocrine diseases (secondary hypertension), however still more cases of essential hypertension are observed that are related to the epidemic of childhood obesity. These are mainly patients with mild systolic hypertension, in adolescent age, often with a positive family history. Despite the increasing incidence of well-known and serious long-term consequences of hypertension for the pediatric patient, the condition is still underdiagnosed. This can be due to several factors, such as absence of clinical signs, inadequate equipment, the incorrect measuring technique, the “percentile” evaluation blood pressure and a high prevalence of white coat hypertension, characteristic of childhood. The final decision about the need for treatment is in the hands of a specialist and it should be preceded by a 24-hour blood pressure monitoring.

Keywords: essential hypertension, diagnostics, ambulatory blood pressure monitoring, home blood pressure measurement, percentile blood pressure charts.