Subclinical Organ Damage in Children and Adolescents with Hypertension: Current Guidelines and Beyond

High Blood Press Cardiovasc Prev. 2019 Oct;26(5):361-373. doi: 10.1007/s40292-019-00345-1. Epub 2019 Oct 24.

Abstract

High blood pressure (BP) is becoming a growing health issue even in children and adolescents. Moreover, BP elevation in youth frequently translates into children and adult hypertension contributing to the development of cardiovascular disease. The detection of early markers of vascular damage, potentially leading to overt cardiovascular disease, is important for clinical decisions about if and how to treat hypertension and can be useful in monitoring the effectiveness of the treatment. The purpose of this review is to summarize the actual knowledge about subclinical organ damage (SOD) in hypertensive children and adolescents and its association with cardiovascular disease in children and young adults. Our focus is especially put on left ventricular mass, pulse wave velocity, carotid intima-media thickness and microalbuminuria. We also want to address the scientific evidence about possible regression of SOD and cardiovascular risk with the use of behavioural and specific anti-hypertensive therapy. Indications from current guidelines are critically discussed.

Keywords: Adolescents; Childhood; Hypertension; Organ damage.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Albuminuria / diagnosis
  • Albuminuria / epidemiology*
  • Albuminuria / physiopathology
  • Asymptomatic Diseases
  • Blood Pressure*
  • Child
  • Female
  • Heart Diseases / diagnosis
  • Heart Diseases / epidemiology*
  • Heart Diseases / physiopathology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Kidney Diseases / diagnosis
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / physiopathology
  • Male
  • Risk Factors
  • Vascular Diseases / diagnosis
  • Vascular Diseases / epidemiology*
  • Vascular Diseases / physiopathology
  • Vascular Remodeling
  • Vascular Stiffness