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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Diagnosis, Epidemiology, and Management of Hypertension in Children
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Diagnosis, Epidemiology, and Management of Hypertension in Children

机译：儿童高血压的诊断，流行病学和管理

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National guidelines for the diagnosis and management of hypertension in children have been available for nearly 40 years. Unfortunately, knowledge and recognition of the problem by clinicians remain poor. Prevalence estimates are highly variable because of differing standards, populations, and blood pressure (BP) measurement techniques. Estimates in the United States range from 0.3% to 4.5%. Risk factors for primary hypertension include overweight and obesity, male sex, older age, high sodium intake, and African American or Latino ancestry. Data relating hypertension in childhood to later cardiovascular events is currently lacking. It is known that BP in childhood is highly predictive of BP in adulthood. Compelling data about target organ damage is available, including the association of hypertension with left ventricular hypertrophy, carotid-intima media thickness, and microalbuminuria. Guidelines from both the United States and Europe include detailed recommendations for diagnosis and management. Diagnostic standards are based on clinic readings, ambulatory BP monitoring is useful in confirming diagnosis of hypertension and identifying white-coat hypertension, masked hypertension, and secondary hypertension, as well as monitoring response to therapy. Research priorities include the need for reliable prevalence estimates based on diverse populations and data about the long-term impact of childhood hypertension on cardiovascular morbidity and mortality. Priorities to improve clinical practice include more education among clinicians about diagnosis and management, clinical decision support to aid in diagnosis, and routine use of ambulatory BP monitoring to aid in diagnosis and to monitor response to treatment.
机译：儿童高血压诊断和管理的国家准则已经适用于近40年。不幸的是，临床医生的知识和认识到问题仍然很差。由于不同的标准，群体和血压（BP）测量技术，流行估计是高度变化的。美国的估计范围为0.3％至4.5％。原发性高血压的危险因素包括超重和肥胖，男性性交，年龄较大，高钠摄入和非洲裔美国人或拉丁裔血统。目前缺乏童年的高血压与后期心血管事件的数据目前缺乏。众所周知，儿童时期的BP在成年期高度预测。有关目标器官损伤的引人注目的数据，包括高血压与左心室肥大，颈动脉 - 内部介质厚度和微蛋白尿的关联。来自美国和欧洲的指导方针包括诊断和管理的详细建议。诊断标准基于诊所读数，动态BP监测可用于确认高血压诊断和鉴定白涂层高血压，掩盖高血压和继发性高血压，以及监测对治疗的反应。研究优先事项包括基于各种群体和关于儿童高血压对心血管发病率和死亡率的长期影响的数据的可靠流行估计。改善临床实践的优先事项包括临床医生的更多教育关于诊断和管理，临床决策支持，以帮助诊断，以及常规使用动态BP监测，以帮助诊断并监测对治疗的反应。

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