儿童高血压的诊治进展

Diagnosis and treatment of hypertension in children

高血压是指以体循环动脉血压增高为主要特征,可伴有心、脑、肾等重要脏器损害的全身血管性疾病,与心脑血管疾病患者的死亡密切相关,已成为全球范围内的重大公共卫生问题.高血压可分为原发性高血压、继发性高血压,儿童原发性高血压由于起病隐匿、进展缓慢,早期症状不明显,导致就诊率低,可引起成年期高血压,儿童继发性高血压大多起病较急,常引起心血管及神经系统症状,若不能得到及时、有效的治疗,可在短期内引起严重并发症.对于高血压患儿,非药物治疗通常作为一线治疗,但相当大比例的儿童最终需要药物治疗,特别是存在靶器官损害的高血压患儿.近年来,虽然儿童高血压的研究有了一定进展,但诊治现状仍然严峻,本文就儿童高血压的诊断、病因及治疗等进行综述.

Hypertension refers to a systemic vascular disease mainly characterized by elevated systemic arterial blood pressure,which can cause damage to heart,brain,kidney and other vital organs.It is closely related to the death of patients with cardiovascular and cerebrovascular diseases and has become a major public health problem worldwide.Hypertension can be divided into primary hypertension and secondary hypertension.Children with primary hypertension have a low visit rate because of the insidious onset,slow progress and none obvious symptoms in the early period,which may contribute to hypertension in their adulthood.Acute onset,cardiovascular and neurological symptoms are common features of the secondary hypertension in children,which may lead to critical complications in a short term if no effective treatments are taken in time.For children with hypertension,non-pharmacological measures are often recommended as first-line therapy,but treatments with drugs are generally required to reduce blood pressure for a substantial proportion of children,especially those with organ damage.In recent years,some progress has been made in the research about pediatric hypertension.Nevertheless,health care providers are still embracing severe challenges in the diagnosis and treatment of pediatric hypertension currently.In this review,we will focus on the diagnosis,etiology and treatment of pediatric hypertension.