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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 71 No. 1, 2017.

Review article

PRIMARY HYPERTENSION IN CHILDREN AND ADOLESCENTS

VESNA HERCEG-ČAVRAK orcid id orcid.org/0000-0002-1723-1791 ; Zagreb Children’s Hospital, Department of Pediatric Cardiology, Zagreb and 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia
VIŠNJA TOKIĆ PIVAC orcid id orcid.org/0000-0002-2589-1888 ; Zagreb Children’s Hospital, Department of Pediatric Cardiology, Zagreb

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Abstract

Primary hypertension is among the most common chronic diseases in adolescence, which is associated with the epidemic of childhood obesity. It presents a risk factor for later development of cardiovascular diseases, and subclinical damages to target organs can occur as early as childhood. Obesity influences development of cardiovascular diseases through metabolic changes such as dyslipidemia, insulin resistance, glucose intolerance, diabetes mellitus type 2, and chronic inflammation.
Maternal obesity, diabetes and hypertension during pregnancy play a role in fetal programming of cardiovascular diseases. Noninvasive methods most often used to estimate functional and structural changes in blood vessels measure the carotid intima-media thickness (cIMT) and arterial stiffness. Ambulatory blood pressure monitoring (ABPM) plays a key role in detecting white coat hypertension and masked hypertension. Clinical monitoring and encouraging lifestyle modifications are important considering both prehypertension and white coat hypertension, as these conditions also pose a risk in target organ damage. Early intervention is important because these changes are reversible in the beginning, but can become stable with time. In isolated systolic hypertension, central aortic pressure is often within normal values. Since not enough
information has yet been gathered on the connection between isolated systolic hypertension and cardiovascular events in adulthood, it is prudent to regularly monitor such adolescents.

Keywords

primary hypertension; white coat hypertension; masked hypertension; arterial stiffness; children and adolescents

Hrčak ID:

184905

URI

https://hrcak.srce.hr/184905

Publication date:

19.7.2017.

Article data in other languages: croatian

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