Breaking News:Experts outline steps to curb rise in youth hypertension – UW Medicine– What Just Happened

Hypertension in children and adolescents is no longer a rare finding but a growing global health concern that must be addressed early to reduce the risk of heart, blood vessel and kidney disease, an expert panel warned today. 

They voiced alarm and outlined corrective steps in a new position paper issued by the International Society of Hypertension and published in the Journal of Hypertension. 

“One of the most important messages of this paper is that accurate measurement and early detection really matter, because when hypertension is identified early, many young people can be treated to prevent future heart and kidney problems,” said first coauthor Dr. Joseph Flynn.  

He is a professor of pediatrics at the University of Washington School of Medicine in Seattle who practices at Seattle Children’s Hospital. 

“We are not just talking about a future risk,” said first coauthor Ruan Kruger, a professor and hypertension specialist at North-West University in South Africa. “In many cases, children with hypertension already show early organ damage, such as thickening of the heart muscle, which is linked to a higher risk of heart disease in adulthood. The adverse effects of hypertension usually seen in middle age are now being detected in children and young people.” 

From 2000 to 2020, hypertension in children under 19 doubled, to 6%. It affects an estimated 114 million children and teens worldwide. Rates tend to be higher in low- and middle-income countries, particularly in sub-Saharan Africa and South Asia. 

The increase in the prevalence of youth hypertension is being driven by a “complex interplay of factors,” the panel said. Such factors include childhood obesity, sedentary lifestyles, diet, chronic stress, sleep disruption, and adverse experiences such as neglect and abuse. 

The paper recommends creating a flexible framework for detection and treatment that different countries can adapt to their circumstances and resources. Many existing guidelines are not applicable in low-resource settings, thereby hindering their application, the panel noted. 

The guidelines stress that early diagnosis and treatment are essential to prevent organ damage in children and related complications in adulthood.  

To achieve that, the panel wrote, regular screening for high blood pressure should be performed, with more frequent checks for children at greater risk due to premature birth, heart, kidney or urologic disease, diabetes or obesity.  

Blood pressure checks should be done using recommended protocols and devices validated for use among children, the panel added, to ensure accurate measurements. 

Lifestyle change should be the first step for managing hypertension in children and adolescents, the authors recommended. These included adopting a reduced-sodium diet that emphasize fruits, vegetables, whole grains, lean meats and low-fat dairy; engaging in moderate-to-vigorous physical activity of at least 60 minutes daily; reducing stress with such practices as mindfulness exercises and yoga; and maintaining a healthy weight. Involving families in adopting these changes is important. 

For most children with mildly elevated hypertension who do not have co-morbid conditions such as kidney disease and diabetes, and those with more severe hypertension that is linked to obesity, lifestyle changes should be tried for six months before starting medications, the panel said. In children with symptoms from their hypertension, more severe hypertension or who have co-morbid conditions, medication should be started immediately, the panel recommended. Regular, long-term follow up into adulthood is also important. 

Ultimately, tackling hypertension in youth will require coordinated public health strategies and policy support that reflects a unified global commitment, the panel concluded. 

Written by Michael McCarthy.

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