Related Subjects:
|Assessing Chest Pain
|Hypertension
|Hypertension in Pregnancy
|Hypertension in Children
|Malignant Hypertension
|Preeclampsia, Eclampsia and HELLP
|Acute Heart Failure
|Chronic Heart Failure
|Essential Hypertension
Hypertension in children is uncommon compared to adults, but when it occurs, it is often due to a secondary cause 🧪.
Early recognition is vital because untreated hypertension in childhood can lead to long-term complications such as kidney damage, stroke, and heart disease 💔.
🔎 Causes
- 🧬 Renal: Chronic kidney disease, renal artery stenosis, polycystic kidney disease.
- 🧪 Endocrine: Hyperaldosteronism (Conn’s), phaeochromocytoma, Cushing’s syndrome, congenital adrenal hyperplasia.
- ❤️ Cardiovascular: Coarctation of the aorta, congenital heart defects.
- 🧠 Neurological: Raised intracranial pressure (tumour, trauma, hydrocephalus), autonomic dysreflexia.
- ⚖️ Obesity-related: Primary hypertension linked to obesity, insulin resistance, and metabolic syndrome.
🩺 Clinical Presentation
- ⚡ Headaches, visual disturbance, seizures (neurological involvement).
- 💧 Oedema, haematuria, flank pain (renal disease).
- 💓 Palpitations, sweating, episodic headaches (pheochromocytoma).
- 💪 Growth retardation, fatigue, poor exercise tolerance.
- 🚸 Often asymptomatic — high BP may be found incidentally during routine checks.
🧪 Investigations
- 🧾 BP in all 4 limbs (to check for coarctation).
- 🧪 Urinalysis, U&E, creatinine for renal function.
- 🖥️ Renal ultrasound, Doppler studies, CT/MRI as indicated.
- 🧬 Hormonal assays (aldosterone, renin, cortisol, catecholamines).
- 👀 Fundoscopy for papilloedema.
💊 Management
- 🎯 Treat the underlying cause (e.g., surgery for coarctation, tumour removal, renal interventions).
- 💉 Antihypertensive medications — ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers.
- 🥦 Lifestyle modifications — healthy diet, weight reduction, regular exercise.
- 👨👩👧 Family education and follow-up to ensure adherence and early detection of complications.
📌 Key Clinical Pearls
- 👶 Always think of secondary hypertension in a child.
- 📈 Ambulatory BP monitoring can rule out “white coat hypertension.”
- 🩺 Children with unexplained growth delay, renal disease, or persistent headaches should have their blood pressure checked.
- 💡 Early recognition and management prevent long-term cardiovascular and renal damage.
