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KNOW THE SIGNS Pediatric Hypertension by Dr. Adrienne Kilgore Walton, MD, MS

Pediatric hypertension occurs in 2%–5% of all pediatric patients.1 It is one of the top five chronic diseases in children and adolescents, and a growing health problem in the wake of the American obesity epidemic. In the last three decades we have seen an eruption of children and adolescents living with obesity. For the U.S, 2011-2014, the prevalence of obesity was 8.9% among 2- to 5-year-olds compared with 17.5% of 6- to 11-year-olds and 20.5% of 12- to 19-year-olds. Obese children and adolescents represent more than 12 million U.S. children — one out of every six children.1 Obese children have an increased risk of developing a range of health problems, including high blood pressure. 30% of obese children and adolescents have elevated blood pressure.2 However, one need not be obese to have hypertension. This is when its recognition may be most difficult, because patients, parents, and health care providers may not actively look for hypertension in normal weight children. 14

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It is of utmost importance to prevent high blood pressure in children. But, it is of equal importance to recognize signs and symptoms, diagnose, and treat hypertension when it is present. High blood pressure in childhood commonly leads to hypertension in adulthood3 and adult hypertension is the leading cause of premature death around the world.4 Consequences of long-standing uncontrolled blood pressure/hypertension have detrimental effects on the body. Among these include heart attacks, strokes, aneurysms or dissections, kidney failure, chronic headaches, difficulty concentrating, poor school or work performance, and fatigue. Not all of these consequences occur in adulthood. Children with hypertension can also show signs of organ damage, specifically cardiac and pathologic vascular changes. Therefore, it is important to understand the following information.

The Voice Winter 2018  
The Voice Winter 2018