Epidemiology, risk factors, and etiology of hypertension in children and adolescents
- Tej K Mattoo, MD, DCH, FRCP
Tej K Mattoo, MD, DCH, FRCP
- Section Editor — Pediatric Nephrology
- Professor of Pediatrics
- Wayne State University School of Medicine
It has become clear that hypertension (HTN) begins in childhood and adolescence and that it contributes to the early development of cardiovascular disease (CVD). The supporting data include clinical studies that demonstrate cardiovascular structural and functional changes in children with HTN and autopsy studies that have shown an association of blood pressure (BP) with atherosclerotic changes in the aorta and heart in children and young adults. (See "Definition and diagnosis of hypertension in children and adolescents" and "Risk factors and development of atherosclerosis in childhood", section on 'Hypertension'.)
In hypertensive adults, multiple randomized trials have shown that reduction of BP by antihypertensive therapy reduces cardiovascular morbidity and mortality. The magnitude of the benefit increases with the severity of the HTN. (See "Hypertension: Who should be treated?".)
Based upon these observations, identifying children with HTN and successfully treating their HTN should have an important impact on long-term outcomes of CVD.
The epidemiology, risk factors, and etiology of childhood HTN will be reviewed here. The diagnosis, evaluation, and treatment of HTN in children and adolescents are reviewed separately. (See "Definition and diagnosis of hypertension in children and adolescents" and "Evaluation of hypertension in children and adolescents" and "Nonemergent treatment of hypertension in children and adolescents".)
Neonatal HTN, including etiology, is also discussed separately. (See "Etiology, clinical features, and diagnosis of neonatal hypertension".)
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- RISK FACTORS
- - Monogenic disorders
- White coat hypertension
- Prenatal and neonatal factors
- Primary hypertension
- Secondary hypertension
- - Renal parenchymal disease
- - Renovascular disease
- - Renal tubular disease
- - Endocrinologic disease
- - Cardiac disease
- - Drugs and toxins
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