Hamdan Medical Journal (previously the Journal of Medical Sciences)

Table of Contents  

Assessment and Management of Hypertension in Children and Adolescents: Part A- Epidemiology, Clinical Evaluationand Prognosis

Hassib Narchi
Published in : Journal of Medical Sciences ; Vol 4, No 1 (2011)
DOI : 10.2174/1996327001104010001


The renewed interest in hypertension in children and adolescents has resulted from the recognition that its presence in adults often has its roots at a younger age. Accurate measurement of blood pressure in children is essential to establish a diagnosis and it should be based on an appropriate technique and comparison to well established population-based standards. The causes are multiple in young children and a thorough evaluation of possible primary causes is imperative.


Adolescent; blood pressure; child; humans; hypertension

View article in  :   PDF    


The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413-46.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JAMA 2003; 289: 2560-72.

Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, et al. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990; 335: 827-38.

Blumenthal S, Epps RP, Heavenrich R, Lauer RM, Lieberman E, Mirkin B, et al. Report of the task force onblood pressure control in children. Pediatrics 1977; 59: I-II, 797-820.

Report of the Second Task Force on Blood Pressure Control in Children--1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 1987; 79: 1-25.

Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996; 98: 649-58.

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555-76.

Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA 2007; 298: 874-9.

McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and prehypertension among adolescents. J Pediatr 2007; 150: 640- 4, 4 e1.

Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004; 113: 475-82.

Rames LK, Clarke WR, Connor WE, Reiter MA, Lauer RM. Normal blood pressure and the evaluation of sustained blood pressure elevation in childhood: the Muscatine study. Pediatrics 1978; 61: 245-51.

Munger RG, Prineas RJ, Gomez-Marin O. Persistent elevation of blood pressure among children with a family history of hypertension: the Minneapolis Children's Blood Pressure Study. J Hypertens 1988; 6: 647-53.

Lauer RM. A family history of risk factors and cardiovascular diseases. Circulation 1991; 84: 1445-6.

Brandao AP, Brandao AA, Araujo EM. The significance of physical development on the blood pressure curve of children between 6 and 9 years of age and its relationship with familial aggregation. J Hypertens Suppl 1989; 7: S37-9.

Gutin B, Basch C, Shea S, Contento I, DeLozier M, Rips J, et al. Blood pressure, fitness, and fatness in 5- and 6- year-old children. JAMA 1990; 264: 1123-7.

Rocchini AP, Katch V, Anderson J, Hinderliter J, Becque D, Martin M, et al. Blood pressure in obese adolescents: effect of weight loss. Pediatrics 1988; 82: 16-23.

Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA 2004; 291: 2107-13.

Din-Dzietham R, Liu Y, Bielo MV, Shamsa F. High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007; 116: 1488-96.

Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002; 288: 1728-32.

Park MK, Menard SM. Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 1987; 79: 907-14.

Wareham JA, Haugh LD, Yeager SB, Horbar JD. Prediction of arterial blood pressure in the premature neonate using the oscillometric method. Am J Dis Child 1987; 141: 1108-10.

Portman RJ, Yetman RJ. Clinical uses of ambulatory blood pressure monitoring. Pediatr Nephrol 1994; 8: 367-76.

Gellermann J, Kraft S, Ehrich JH. Twenty-four-hour ambulatory blood pressure monitoring in young children. Pediatr Nephrol 1997; 11: 707-10.

Gomez-Marin O, Prineas RJ, Sinaiko AR. The Sodium- Potassium Blood Pressure Trial in Children. Design, recruitment, and randomization: the children and dolescent blood pressure program. Control Clin Trials 1991; 12: 408-23.

Rosner B, Prineas RJ, Loggie JM, Daniels SR. Blood pressure nomograms for children and adolescents, by height, sex, and age, in the United States. J Pediatr 1993; 123: 871-86.

Sinaiko AR, Gomez-Marin O, Prineas RJ. Prevalence of "significant" hypertension in junior high school-aged children: the Children and Adolescent Blood Pressure Program. J Pediatr 1989; 114: 664-9.

Fixler DE, Laird WP. Validity of mass blood pressure screening in children. Pediatrics 1983; 72: 459-63.

Sorof JM, Poffenbarger T, Franco K, Portman R. Evaluation of white coat hypertension in children: importance of the definitions of normal ambulatory blood pressure and the severity of casual hypertension. Am J Hypertens 2001; 14: 855-60.

Stergiou GS, Yiannes NJ, Rarra VC, Alamara CV. Whitecoat hypertension and masked hypertension in children. Blood Press Monit 2005; 10: 297-300.

Pickering TG. Principles and techniques of blood pressure measurement. Cardiol Clin 2002; 20: 207-23.

Flynn JT, Alderman MH. Characteristics of children with primary hypertension seen at a referral center. Pediatr Nephrol 2005; 20: 961-6.

Gidding SS. Measuring children's blood pressure matters. Circulation 2008; 117: 3163-4.

Falkner B, Gidding SS, Portman R, Rosner B. Blood pressure variability and classification of prehypertension and hypertension in adolescence. Pediatrics 2008; 122: 238-42.

Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995; 8: 657-65.

Fuentes RM, Notkola IL, Shemeikka S, Tuomilehto J, Nissinen A. Tracking of systolic blood pressure during childhood: a 15-year follow-up population-based family study in eastern Finland. J Hypertens 2002; 20: 195-202.

Donahue RP, Prineas RJ, Gomez O, Hong CP. Tracking of elevated systolic blood pressure among lean and overweight adolescents: the Minneapolis Children's Blood Pressure Study. J Hypertens 1994; 12: 303-8.

Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and metaregression analysis. Circulation 2008; 117: 3171-80.

Sun SS, Grave GD, Siervogel RM, Pickoff AA, Arslanian SS, Daniels SR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics 2007; 119: 237-46.

Assadi F. Effect of microalbuminuria lowering on regression of left ventricular hypertrophy in children and adolescents with essential hypertension. Pediatr Cardiol 2007; 28: 27-33.

Daniels SR, Loggie JM, Khoury P, Kimball TR. Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 1998; 97: 1907-11.

Rocchini AP, Moorehead C, Katch V, Key J, Finta KM. Forearm resistance vessel abnormalities and insulin resistance in obese adolescents. Hypertension 1992; 19: 615-20.

Raitakari OT, Juonala M, Kahonen M, Taittonen L, Laitinen T, Mäki-Torkko N, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 2003; 290: 2277-83.

Oren A, Vos LE, Uiterwaal CS, Gorissen WH, Grobbee DE, Bots ML. Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: the Atherosclerosis Risk in Young Adults study. Int J Obes Relat Metab Disord 2003; 27: 1383-90.

Li S, Chen W, Srinivasan SR, Bond MG, Tang R, Urbina EM, et al. Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA 2003; 290: 2271-6.

Sorof JM, Alexandrov AV, Garami Z, Turner JL, Grafe RE, Lai D, et al. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol 2003; 18: 1020-4.

Mitchell P, Cheung N, de Haseth K, Taylor B, Rochtchina E, Islam FM, et al. Blood pressure and retinal arteriolar narrowing in children. Hypertension 2007; 49: 1156-62.

Lande MB, Kaczorowski JM, Auinger P, Schwartz GJ, Weitzman M. Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States. J Pediatr 2003; 143: 720-4.

Lande MB, Adams H, Falkner B, Waldstein SR, Schwartz GJ, Szilagyi PG, et al. Parental assessments of internalizing and externalizing behavior and executive function in children with primary hypertension. J Pediatr 2009; 154: 207-12.

Berenson GS, Wattigney WA, Tracy RE, Newman WP 3rd, Srinivasan SR, Webber LS, et al. Atherosclerosis of the aorta and coronary arteries and cardiovascular risk factors in persons aged 6 to 30 years and studied at necropsy (The Bogalusa Heart Study). Am J Cardiol 1992; 70: 851-8.

McGill HC, Jr., McMahan CA, Malcom GT, Oalmann MC, Strong JP. Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol 1995; 15: 431-40.

Berenson GS, Srinivasan SR, Bao W, Newman WP, 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650-6.

Cutler JA, MacMahon SW, Furberg CD. Controlled clinical trials of drug treatment for hypertension. A review. Hypertension 1989; 13: I36-44.

Hanevold C, Waller J, Daniels S, Portman R, Sorof J. The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics 2004; 113: 328-33.

McNiece KL, Gupta-Malhotra M, Samuels J, Bell C, Garcia K, Poffenbarger T, et al. Left ventricular hypertrophy in hypertensive adolescents: analysis of risk by 2004 National High Blood Pressure Education Program Working Group staging criteria. Hypertension 2007; 50: 392- 5.

Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr 2008; 152: 73-8.

Trieber FA, McCaffrey F, Pflieger K, Raunikar RA, Strong WB, Davis H. Determinants of left ventricular mass in normotensive children. Am J Hypertens 1993; 6: 505-13.

Burke GL, Arcilla RA, Culpepper WS, Webber LS, Chiang YK, Berenson GS. Blood pressure and echocardiographic measures in children: the Bogalusa Heart Study. Circulation 1987; 75: 106-14.

Jiang X, Srinivasan SR, Bao W, Berenson GS. Association of fasting insulin with longitudinal changes in blood pressure in children and adolescents. The Bogalusa Heart Study. Am J Hypertens 1993; 6: 564-9.

Jiang X, Srinivasan SR, Bao W, Berenson GS. Association of fasting insulin with blood pressure in young individuals. The Bogalusa Heart Study. Arch Intern Med 1993; 153: 323- 8.

Jiang X, Srinivasan SR, Webber LS, Wattigney WA, Berenson GS. Association of fasting insulin level with serum lipid and lipoprotein levels in children, adolescents, and young adults: the Bogalusa Heart Study. Arch Intern Med 1995; 155: 190-6.

Taittonen L, Uhari M, Nuutinen M, Turtinen J, Pokka T, Akerblom HK. Insulin and blood pressure among healthychildren. Cardiovascular risk in young Finns. Am J Hypertens 1996; 9: 194-9.

Kanai H, Matsuzawa Y, Tokunaga K, Keno Y, Kobatake T, Fujioka S, et al. Hypertension in obese children: fasting serum insulin levels are closely correlated with blood pressure. Int J Obes 1990; 14: 1047-56.

Rocchini AP, Key J, Bondie D, Chico R, Moorehead C, Katch V, et al. The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. N Engl J Med 1989; 321: 580-5.

Stamler J. Blood pressure and high blood pressure. Aspects of risk. Hypertension 1991; 18: I95-107.

MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, et al. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990; 335: 765-74.

Add comment 

Home  Editorial Board  Search  Current Issue  Archive Issues  Announcements  Aims & Scope  About the Journal  How to Submit  Contact Us
Find out how to become a part of the HMJ  |   CLICK HERE >>
© Copyright 2012 - 2013 HMJ - HAMDAN Medical Journal. All Rights Reserved         Website Developed By Cedar Solutions INDIA