Arterial hypertension in pediatric age
Introduction
Arterial hypertension is beginning to the end of the 18th century where there was talk of it, but its enunciation was by exclusion, it is not until 1876 when the first devices are manufactured, and until 1908 that the Russian doctor, Nicholai Korotkoff shows the sphygmomanometer ofMercury which we keep to this day. In 1990, Mac Mahón publishes a natural history of arterial hypertension, but a great contribution to the knowledge of this natural story was the study of Framingham, which began in 1948.
Developing
The purpose was to evaluate a normal community through medical records, ensuring that the sample size allowed to extrapolate information to other communities. The appearance of new cases of hypertension and coronary heart disease and its relationship with epidemiological variables such as sex and age was monitored. The study of Framingham of the Heart, documented the relationship between arterial hypertension and coronary heart disease, also highlighted the multiple causality of arterial hypertension and described the prevalence, incidence, morbidity and mortality.
Arterial hypertension (HA) was identified as the main source of combined mortality and morbidity, representing 7% of the years of life adjusted for disability worldwide. It is one of the main potentially modifiable cardiovascular risk factors. It is also one of the main clinical problems of adult medicine, and is one of the most common chronic diseases in adolescents.
In addition to the primary form of hypertension (essential hypertension), it is an important complication of other chronic diseases such as: type 1 diabetes mellitus (DM1), type 2 diabetes mellitus (DM2), chronic renal disease (ERC), coarstation of the aorta, congenital adrenal hyperplasia and others. Because the DMT2 is relatively rare in caucasic children and adolescents, children with overweight and obesity, especially those with carbohydrate intolerance and insulin resistance, must be treated as a potential risk group for Ha.
Arterial hypertension is also increasing. The adoption of blood pressure (PA) definitions and the normalization of the National Program for High Blood Pressure ’(NHBPEP Acronym in English) 2004- Fourth Report has standardized the classification of PA in the pediatric population. It is estimated that the percentage of children and adolescents diagnosed with arterial hypertension (HA) has doubled in the last two decades.
The current prevalence of HA in the pediatric population is around 3% to 5%, while that of primary hypertension (HP) reaches 10% to 15%, and these values are mainly attributed to the great increase in childhood obesity. The etiology of pediatric ha can be secondary, more frequently associated with nephropathies, or primary, attributed to genetic causes with environmental influence, predominantly in adolescents.
In Mexico, its prevalence varies between 1 to 5%, associating risk factors such as: “in utero” malnutrition, on weight-obesity, sedentary lifestyle and metabolic alterations. Currently, it is considered that the school age of 9 to 12 years begins to present prehipertension, which is an important factor for the development of hypertension in major ages, as well as a greater number of complications.
The Cuban Guida of Arterial Hypertension (GCHTA), has its origins in the first National Hypertension Program, which was published in 1998. Subsequently, the HTA guides began to be edited, which were written and updated through workshops or expert meetings, by members of the National Advisory Commissions and the provinces. The editions of the Guide were in the years 2003, 2006 and 2008, and the last in 2017 and were based on updates according to the development of knowledge and contributions of important documents such as the North American joint (JNC) and the guides edited by theEuropean Society of Arterial Hypertension and National Institute for Health and Clinical Excellence (Nice-Siglas in English) of the United Kingdom.
conclusion
In Cuba, Gutiérrez et al., They observed that the age group of 13-18, the male sex, the family pathological history of essential arterial hypertension and excess malnutrition are factors that were associated with patients with essential essential arterial hypertension. Pediatric has usually been asymptomatic, but up to 40% of hypertensive children have left ventricular hypertrophy (HVI) in the initial diagnosis of Ha. Although oligosintomatic in childhood, HVI is a precursor to arrhythmias and heart failure in adults.
In addition, pediatric has associated with the development of other changes in target organs, reducing arterial distensibility and arteriolar narrowing of the retina. The early diagnosis and treatment of children are associated with a lower risk of ha and an increase in carotid atheromatosis in adult life. Therefore, periodic reviews of blood pressure in children and adolescents are recommended.
Leave feedback