1/2007Update on arterial hypertension in children

NILZETE LIBERATO BRESOLIN (Institution: Hospital Infantil Joana de Gusmăo – Florianópolis – Santa Catarina – Brasil)

Summary
In the article authors present current knowledge about genesis, diagnosis and treatment of arterial hypertension in children. The most common factors related to high blood pressure in children are obesity, renal parenchymal disease, aortic coarctation and kidney vascular lesions. The BP found must be compared to the reference values considering normal BP, systolic blood pressure (SBP) and diastolic blood pressure (DBP) < 90th percentile for gender, age, and height on = 3 occasions. The strategies for treatment of hypertension are no-pharmacological (weight control together, dietary change and physical exercise) and pharmacological ones. When pharmacological intervention is indicated, it should be initiated with a single dose and with the smaller doses recommended. Once the maximum dose is reached, or there are adverse effects, a second drug class should be associated. The goal is to reduce the BP to under 95th percentile unless concurrent conditions are present (diabetes, kidney disease, lesion in the target organ), in which case BP should be lowered to under 90th percentile. Severe, symptomatic hypertension should be treated with intravenous antihypertensive drugs..

Key words: arterial hypertension, blood pressure, children, guidelines