Primary hypertension in children

Primary hypertension in children is not as common as in adults; recent studies suggest a prevalence of 3-4 % in the pediatric population. However, more recent reports have highlighted an increasing prevalence of HTN and prehypertension, likely due to childhood obesity. Given the global burden of hypertension, identifi cation and management of primary HTN is benefi - cial to the individual child and has important implications for society as well, particularly since tracking studies have established that adult primary HTN has its antecedents during childhood. Studies are limited on the pathophysiology of primary HTN in children; however, evidence suggests that the proposed multifactorial and complex genetic, environmental, and biological interactions involved in the development of hypertension in adults provide a basis to understand HTN in children as well. Primary HTN in young children is a diagnosis of exclusion, and selective workup is needed to rule out any underlying secondary causes; however, in adolescents, primary hypertension is much more common than secondary hypertension. Early identifi cation and management of elevated BP in the pediatric population is important to decrease the risks for end-organ injury in both the pediatric and adult population.