Practical guidelines on diagnosis and treatment of arterial hypertension in children and adolescents

Pediatric hypertension is a growing public health problem as numerous studies indicate that elevated blood pressure levels are more common in children and adolescents than previously thought. Hypertension is transmitted from childhood, especially adolescence, into adulthood, thereby increasing the risk of cardiovascular disease in adulthood. Therefore, numerous international and national guidelines for the diagnosis and treatment of pediatric hypertension have been made. These have been periodically updated from the first recommendations of 1977 to the 2016 European guidelines of the European Society of Hypertension (ESH) and the guidelines of the American Academy of Pediatrics (AAP) which were published in 2017. Pediatric cardiologists and nephrologists, as well as school physicians, participated in the development of our guidelines, guided by new insights that have been made in this field in recent years, tailored to our capabilities and circumstances. The European and US guidelines are in agreement with a number of recommendations, but they differ in some important details such as the classification of hypertension. In doing so, we have complied with European directives.

The purpose of these guidelines is to be practical and understandable, with clear recommendations on how to diagnose hypertension in children and how to treat such patients. We have tried to summarize all of the important recommendations into tables and tabs so that they are as transparent and easily accessible as possible. Our intention was to make these guidelines useful in the day-to-day clinical work of all pediatric physicians, pediatricians, school and family medicine physicians, as well as pediatric cardiologists and nephrologists. We believe that these guidelines will encourage physicians to better prevent, diagnose, and treat hypertension in children and adolescents, and thus contribute to reducing cardiovascular disease in adulthood. 

Key words:
adolescents; blood pressure; children; diagnostic; hypertension; management of high blood pressure