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Management of blood pressure in children

Malatesta-Muncher, Rossana; Mitsnefes, Mark M.

Current Opinion in Nephrology and Hypertension: May 2012 - Volume 21 - Issue 3 - p 318–322
doi: 10.1097/MNH.0b013e328351c415

Purpose of review This review summarizes recent insights into the epidemiology of primary hypertension in children, with emphasis on the most important risk factors for the development of hypertension, and also updates current options for treating primary hypertension in children.

Recent findings There is growing evidence that the prevalence of hypertension has increased over the past decade and that the epidemic of obesity has played a key role in the increase of blood pressure (BP) in the USA and abroad. Recent studies have shown that in addition to obesity, environmental factors such as second-hand smoking and sedentary lifestyle are important in development of hypertension even in preschool age children. Studies also have confirmed the effect of vegetables and fruits on lowering BP. Recent clinical trials of valsartan and olmesartan have provided efficacy and safety information for use in children.

Summary The increased prevalence of hypertension in children in recent years emphasizes the need for a more aggressive approach to screen and diagnose elevated BP even in early childhood. Early initiation of treatment is important to decrease the risk of cardiovascular morbidity in adulthood.

Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

Correspondence to Mark M. Mitsnefes, MD, MS, Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7022, Cincinnati, OH 45229, USA. Tel: +1 513 636 4531; fax: +1 513 636 7407; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.