FIU MN 580 Pediatric Hypertension Discussion

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Pediatric hypertension is now a common condition in the U.S, causing morbidity and mortality among children. In children, hypertension is when a child records blood pressure above the 95th percentile for children of the same sex, age, and height. In most cases, the children do not show the symptoms of hypertension in the early stages of life; however, these symptoms are visible later in their lives (MSD Manual Professional Edition, 2022). The etiology or pathophysiology of hypertension in children includes primary or secondary hypertension. Primary hypertension is common in children above the age of six; however, secondary hypertension is more common among children under the age of 3 years. Primary hypertension does not have a known cause; secondary hypertension is often caused by another disorder, such as kidney disease.

The factors determining blood pressure in children and adults include the balance between cardiac output and vascular resistance. In addition, other factors affecting blood pressure include the renin-angiotensin-aldosterone system, sympathetic nervous system, and sodium transport. The complications of pediatric hypertension can be acute or chronic. The acute complications of hypertension in children are uncommon and related to hypertensive emergencies where there is end-organ damage. In this case, the affected organs can include the central nervous system, heart, eyes, and kidneys. On the other hand, the chronic complications of hypertension among children are rare and often do not present themselves until adolescence.

The data is for the U.S; however, in the whole world, the information about pediatric hypertension is less clear because of the differences in regions, reference data, and methodology used to collect the data (Song et al., 2019). In the U.S, the prevalence and epidemiology of pediatric hypertension range between 2.32 percent and 3.9 percent; however, the high normal range is between 3.4 percent and 4 percent. The reported prevalence is about 4 percent. This rate may increase due to the increase in obesity incidence among children. Among children, obesity is twice as compared as adolescents; therefore, it makes children more susceptible to hypertension.

The physical exam findings for a hypertensive child may be normal; however, the signs of hypertension may be present, calling for proper attention. The physical exam findings may include general, vital signs, head and neck, eyes, skin, chest, abdomen, and extremities. For instance, an examination of the eyes may reveal proptosis, a hyperthyroidism condition (MSD Manual Professional Edition, 2022). Moreover, an individual should watch out for moon facies or thyroid enlargement. The differential diagnosis for pediatric hypertension includes hyperaldosteronism, coarctation of the aorta, renal artery stenosis, and chronic kidney disease.

The diagnosis of pediatric hypertension includes using sphygmomanometry, oscillometric devices, and testing for etiology. The treatment and management of hypertension in children include weight reduction, dietary modification, exercise, and drug treatment (MSD Manual Professional Edition, 2022). The mode of treatment will depend on the stage of hypertension, such that children with evidence of end-organ damage or diabetes should have a more rapid and correct therapy to manage their conditions and avoid further organ failure. All the treatments aim to reduce the blood pressure to below the 90th percentile for all children of that age, sex, and height.

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