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Screening diagnosis and treatment of hypertension in obese children: an international policy comparison

机译：肥胖儿童高血压的筛查诊断和治疗：国际政策比较

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Hypertension in obese children may require a different diagnostic and treatment approach from that for children with secondary hypertension, yet there is neither consensus nor a clear guideline. The aim of this study was to assess how obese children with hypertension are currently diagnosed and treated by paediatric nephrologists, what obstacles exist and what can be improved. In the period May–November 2014, an online questionnaire was sent to all members of the European Society for Paediatric Nephrology (n = 2148). Questions focused on current practices and obstacles regarding screening, diagnosis and treatment of hypertension in obese children. A total of 214 paediatric nephrologists responded. Although nearly 100 % agreed that screening of obese children for hypertension is indicated, it was current practice in only 56 % of participating countries; 88 % of respondents diagnosed hypertension with 24-h ambulatory blood pressure measurement. Diagnostics used to rule out causes or consequences of hypertension varied among the respondents; they included, in particular, the use of serum renin/aldosterone, urine sodium/potassium, and dimercaptosuccinic acid scan. Concerning treatment, 45 % of respondents preferred to start treatment with a lifestyle program, 2 % with antihypertensive medication, and 40 % with both. For 73 % of respondents, angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers were the drugs of first choice. The findings of this study emphasize the urgent need for an international guideline for screening, diagnosis and treatment of hypertension in obese children.Electronic supplementary materialThe online version of this article (doi:10.1007/s40620-016-0277-6) contains supplementary material, which is available to authorized users.
机译：肥胖儿童的高血压可能需要与继发性高血压儿童不同的诊断和治疗方法，但目前尚无共识，也没有明确的指南。这项研究的目的是评估儿科肾脏病医生目前如何诊断和治疗肥胖的高血压儿童，存在哪些障碍以及可以改善哪些障碍。在2014年5月至11月期间，在线问卷已发送给欧洲小儿肾脏病学会的所有成员（n = 2148）。问题集中在肥胖儿童筛查，诊断和治疗高血压的现行做法和障碍。总共214位儿科肾脏病医生对此做出了回应。尽管将近100％的人同意对肥胖儿童进行高血压筛查，但目前只有56％的参与国采用这种做法; 88％的受访者通过24小时动态血压测量来诊断出高血压。用来排除高血压原因或后果的诊断方法因受访者而异。它们尤其包括血清肾素/醛固酮，尿钠/钾和二巯基琥珀酸扫描的使用。在治疗方面，有45％的受访者倾向于以生活方式计划开始治疗，有2％的患者接受降压药治疗，有40％的人都接受治疗。对于73％的受访者来说，血管紧张素转化酶抑制剂或血管紧张素受体阻滞剂是首选药物。这项研究的结果强调了迫切需要针对肥胖儿童高血压进行筛查，诊断和治疗的国际指南。电子补充材料本文的在线版本（doi：10.1007 / s40620-016-0277-6）包含补充材料，可供授权用户使用。

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