Primary Hypertension in Children and Adolescents: Risk Factors and Vascular Damage

Martina Kos; Ines Drenjančević; Silvija Pušeljić; Ivana Jukić*

doi:10.26332/seemedj.v7i2.287

Martina Kos Clinic of Pediatrics, University Hospital Center Osijek, Osijek, Croatia; Department of Pediatrics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ines Drenjančević Department of Physiology and Immunology, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Scientific Centre of Excellence for Personalized Health Care University of Osijek, Osijek, Croatia
Silvija Pušeljić Clinic of Pediatrics, University Hospital Centre Osijek, Osijek, Croatia; Department of Pediatrics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ivana Jukić* Department of Physiology and Immunology, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Scientific Centre of Excellence for Personalized Health Care University of Osijek, Osijek, Croatia

DOI: https://doi.org/10.26332/seemedj.v7i2.287

Abstract

The incidence of primary hypertension is on the rise in the pediatric population, with an approximate prevalence ranging from 3% to 5%. The most significant risk factors for the onset and development of primary hypertension are well-known, and some of them are preventable, including increased salt consumption and obesity. Connected with metabolic risk factors, elevated blood pressure in childhood is carried into adulthood. Primary hypertension is associated with attenuated vascular responses to various physiological stimuli in both peripheral microcirculation and systemic macrocirculation in adults and children. Endothelial dysfunction is one of the most important features of arterial hypertension, together with an increased level of oxidative stress – both determinants significantly contribute to all the pathophysiological changes observed in hypertension. Systemic arterial hypertension has emerged as a prevalent cardiovascular risk factor associated with substantial morbidity and mortality. Hence, the timely identification of individuals with elevated blood pressure and early-life blood pressure management could serve as a crucial strategy to mitigate the risk of cardiovascular disease and mortality in adulthood.

Sažetak

Učestalost primarne hipertenzije u porastu je u pedijatrijskoj populaciji, s približnom prevalencijom od 3 do 5 %. Najznačajniji čimbenici rizika za nastanak i razvoj primarne hipertenzije dobro su poznati, a neke je od njih moguće spriječiti, uključujući povećanu konzumaciju soli i pretilost. Povezano s metaboličkim čimbenicima rizika, povišen krvni tlak u djetinjstvu prenosi se u odraslu dob. Primarna hipertenzija povezana je s oslabljenim vaskularnim odgovorima na različite fiziološke podražaje u perifernoj mikrocirkulaciji i sistemskoj makrocirkulaciji kod odraslih i djece. Disfunkcija endotela jedna je od najvažnijih značajki arterijske hipertenzije, zajedno s povećanom razinom oksidativnog stresa - oba čimbenika značajno doprinose svim patofiziološkim promjenama koje se opažaju kod hipertenzije. Sistemska arterijska hipertenzija postala je raširen kardiovaskularni čimbenik rizika povezan sa značajnim morbiditetom i smrtnošću. Stoga bi pravovremena identifikacija osoba s povišenim krvnim tlakom i upravljanje krvnim tlakom u ranom životu moglo poslužiti kao ključna strategija za smanjenje rizika od kardiovaskularnih bolesti i smrtnosti u odrasloj dobi.