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  • Title: Hypertension in children: approach to management.
    Author: Saxena A.
    Journal: Indian Heart J; 2010; 62(5):434-9. PubMed ID: 23189886.
    Abstract:
    Hypertension in children is an important often under diagnosed condition. There are no absolute values of normal blood pressure in children as it varies with age, gender and height. Normative blood pressure data is available for different ages, sexes and heights, the diagnosis of hypertension should be based on these values. It is recommended that all children over the age of 3 years should have blood pressure measured whenever seen by a doctor. Essential hypertension can occur in children, but hypertension secondary to an underlying cause (most often renal) is more likely. Secondary hypertension tends to be more severe, sustained and at times uncontrolled. Evaluation includes a thorough history and physical examination and certain basic laboratory tests. All attempts should be made to look for the etiology in cases where secondary hypertension is suspected. Management of hypertension in children must incorporate non pharamacological measures including weight reduction, exercise and dietary modifications. Pharamacological treatment is indicated for; a) symptomatic hypertension, b) if there is evidence of end organ damage and c) for those unresponsive to nonpharmacological treatment. A number of drugs are available for children with hypertension; commonly used ones are calcium channel blockers, beta blockers, angiotensin converting enzyme inhibitors and diuretics. Choice of a drug depends on the underlying cause of hypertension and presence of comorbidity, if any.
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