1P-S6-5

UPDATE PEDIATRIC HYPERTENSION

Alan B Gruskin M.D.

Wayne State University School of Medicine & Children’s Hospital of Michigan Detroit Michigan, USA

Significant advancement in understanding all components of blood pressure regulation in children has occurred over the past few years. This overview focuses on the important advances in the technique of taking blood pressure in children, pathophysiology of hypertension, diagnosis and treatment of hypertensive disease in children. Recent studies have challenged the convention recommendations as to what size, length and width, to use when taking blood pressures in children of varying body size. These data suggest that new recommendations may need to be considered. Also 24 hour ambulatory blood pressure measurements have been used to understand the pathophysiology and diagnosis hypertensive disease in children. Recent advances in genetics and cell physiology have identified genes and transport mechanisms involved in multiple diseases causing primary and secondary forms of hypertension. As regards primary hypertension the role of obesity and various types of hypertension, isolated systolic, isolated diastolic and combined has become more clearly defined. Prospective controlled clinical trials in statistically significant numbers of hypertensive children with primary and secondary hypertension have defined the efficacy and safety of some of the newer antihypertensive agents.