2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents
Abstract
Increasing prevalence of hypertension (HTN) in children and adolescents has become a significant public health issue driving a considerable amount of research. Aspects discussed in this document include advances in the definition of HTN in 16 year or older, clinical significance of isolated systolic HTN in youth, the importance of out of office and central blood pressure measurement, new risk factors for HTN, methods to assess vascular phenotypes, clustering of cardiovascular risk factors and treatment strategies among others. The recommendations of the present document synthesize a considerable amount of scientific data and clinical experience and represent the best clinical wisdom upon which physicians, nurses and families should base their decisions. In addition, as they call attention to the burden of HTN in children and adolescents, and its contribution to the current epidemic of cardiovascular disease, these guidelines should encourage public policy makers to develop a global effort to improve identification and treatment of high blood pressure among children and adolescents.
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Considerable emphasis on the methodology of OBP measurements has been put in recent European and American guidelines for pediatric hypertension, stressing standardized conditions, validated monitors with appropriate cuff size and multiple measurements.
“Considerable emphasis on the methodology of OBP measurements has been put in the recent European and American guidelines for pediatric hypertension, by stressing the importance of standardized conditions, use of validated monitors with appropriate cuff size and performing multiple measurements [174,175]”
The reproducibility of BP information provided by HBPM and ABPM was shown to be similar by direct comparison in the same individuals, or even higher for HBPM.
“An important issue to consider is the reproducibility of BP information provided by HBPM and ABPM, respectively, which was shown to be similar by a direct comparison of HBPM and ABPM data in the same individuals [18,170], or even higher for HBPM [20]”
Similar pooled correlation coefficients of nocturnal systolic HBP and ABP were reported with LVMI, urinary albumin excretion and cIMT.
“Moreover, similar pooled correlation coefficients of nocturnal systolic HBP and ABP were reported with LVMI, urinary albumin excretion and cIMT [170].”
A meta-analysis of six studies including 1404 individuals showed pooled correlation coefficients between nocturnal HBPM and night-time BP by ABPM of 0.70/0.72 and pooled differences of 1.4/−0.2 mmHg (systolic/diastolic).
“A meta-analysis of six studies including 1404 individuals compared nocturnal HBPM with night-time BP by ABPM and showed pooled correlation coefficients between them of 0.70/0.72 and pooled differences of 1.4/−0.2 mmHg (systolic/diastolic) [170].”
In the same meta-analysis, 2 studies including 212 individuals showed weighted agreement of 77% between nocturnal HBPM and ABPM in detecting nondippers, close to the reproducibility of each method.
“In the same meta-analysis, 2 studies including 212 individuals investigated the agreement between nocturnal HBPM and ABPM in detecting nondippers and showed weighted agreement of 77%, which is close to the reproducibility of each of the two methods [170].”
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2018 ESC/ESH Guidelines for the management of arterial hypertension
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- Authors
- Lurbe, E., Agabiti-Rosei, E., Cruickshank, J. K., Dominiczak, A., Erdine, S., Hirth, A., Invitti, C., Litwin, M., Mancia, G., Pall, D., Rascher, W., Redon, J., Schaefer, F., Seeman, T., Sinha, M., Stabouli, S., Webb, N. J., Wühl, E., & Zanchetti, A.
- Affiliations
- University of Debrecen (HU)
- Corresponding author
- Lurbe, Empar
- ORCID
- Venue
- Journal of Hypertension
- Published
- 2016-10
- Volume
- 34
- Issue
- 10
- Pages
- 1887-1920
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2491849061
- Cited by
- 1,379
- References
- 11
- Citations by year
- 2026: 102 · 2025: 136 · 2024: 147 · 2023: 166 · 2022: 200 · 2021: 164 · 2020: 159 · 2019: 115 · 2018: 117 · 2017: 54 · 2016: 14 · 2015: 1
- FWCI
- 82.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- pediatric hypertension, adolescent hypertension, antihypertensive therapy, isolated systolic hypertension, ambulatory blood pressure monitoring, cardiovascular risk factors, vascular phenotype, hypertension prevalence
- MeSH terms
- Adolescent, Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Child, Humans, Hypertension, Risk Factors, Comorbidity, Prevalence
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