Recent Advances in Childhood Hypertension

Dear Colleagues,

Hypertension, identifiable in children and adolescents, is independent risk factor for hypertension and for hypertension-related cardiovascular consequences in adults. In recent studies, an increased prevalence of childhood hypertension has been demonstrated to be accountable to essential hypertension and a product of epidemic obesity. Moreover, in children, the secondary causes of hypertension must also be excluded; the younger the child, the higher the likelihood of secondary hypertension. In earlier studies, elevated blood pressure was found in 1−2% of children and adolescents, increasing to 4−5% in newer ones, indicating a significant health problem. The major risk factors for essential hypertension development are obesity and positive family history of hypertension—a surrogate marker of genetic predisposition; however, its aetiology is multifactorial, including numerous environmental and genetic factors. Obesity and the closely related insulin resistance are important components of metabolic syndrome, which are also increasingly recognized in children with hypertension, probably due to common pathophysiological mechanisms. Despite the fact that hypertension has become one of the most common chronic diseases of childhood, relatively little attention has been paid to its management, treatment, and prevention, and the latest European guidelines were published five years ago. It has been recognized that long-term cohort studies directly linking childhood high blood pressure to cardiovascular events (e.g., stroke, myocardial infarction) in adults are needed. Some insights into the effects of  hypertension on child health have been obtained from children with secondary hypertension and from examination of hypertensive target organ damage. Furthermore, good long-term studies investigating the benefits of antihypertensive treatment in the pediatric age group, and the long-term effects of antihypertensive medications on growth and development have to be performed; additionally, there are increasing pediatric data available for antihypertensive medications, enabling effective and safe treatment when indicated.

Cardiovascular prevention is one of the most important tasks of hypertension management, including primordial prevention. In addition, establishing some early predictors of cardiovascular risk—e.g., clinical, metabolic, biochemical, or genetic—for early detection, treatment, and prediction of outcome are of the utmost importance. 

In this Special Issue, we would like to include some new points regarding childhood hypertension epidemiology, pathophysiology, management, treatment, and prevention. We encourage the submission of original research, reviews, meta-analyses, or interesting case studies which address the recent advances in the investigated field, for example, in the following areas: studies obtaining good referential normative blood pressure values for oscillometric devices for home and office measurements; research in the field of pediatric ambulatory blood pressure monitoring; research in genetics; studies investigating the natural course of pediatric hypertension; metabolic syndrome; the impact of treatment on prevention or amelioration of short- and long-term cardiovascular consequences of hypertension. In addition, studies investigating the effectiveness and safety of antihypertensive medications—especially some older ones—are welcome, as well as studies aiding the search for potential new early markers of cardiovascular risk.

Prof. Dr. Nataša Marčun Varda
Guest Editor

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• hypertension
• high blood pressure metabolic syndrome
• Genetics
• early cardiovascular markers essential hypertension