Childhood hypertension: An update on etiology, diagnosis, and treatment

Since the publication of the 1993 issue of Pediatric Clinics of North America that was devoted entirely to childhood hypertension, much has been published relating to the development, investigation, and treatment of elevated blood pressure in children and adolescents. The incorporation of blood pressure measurement into the routine pediatric examination has enabled both the discovery of significant asymptomatic hypertension secondary to a previously undetected disorder and the confirmation that mild elevations in blood pressure during childhood are more common than previously recognized, particularly in adolescents. Although hypertension may be a sign of underlying cardiac; endocrine; or, more commonly, renovascular or renal parenchymal disease, elevated blood pressure may also represent an early onset of essential hypertension. This article provides pediatricians with an overview and update of the poignant literature published since the 1993 Clinics , with selected earlier references. The organization of the article relies heavily on the structure of the 1993 Clinics , and the reader is referred to that publication for more extensive background references.