Management of High Blood Pressure in Pediatrics

The diagnosis of systemic hypertension is missed in the majority of cases as familiarity with pediatric hypertension among clinicians is poor so it is usually a silent killer. We aimed to evaluate the management lines for systemic hypertension of children attended to ASSIUT university childrens hospital with systemic hypertension. Patients and methodsit is a prospective study that included all cases with systemic hypertension admitted to Assiut university childrens` hospital from 1st July 2015 to - 31 January 2016. Patients were evaluated for detection of the causes of secondary hypertension, associated comorbidities including fasting lipid panel and fasting serum glucose level. and for target organ damage including retinopathy, nephropathy, left ventricular hypertrophy, and neuropathy. They were also evaluated for blood pressure control using pharmacological and non pharmacological lines. Results we found that all patients were treated with antihypertensive drugs, 72 % of patients were on polytherapy while the rest of patients were on monotherapy. Blood pressure was controlled in all patients on monoyherapy but controlled only in 73 % of patients on polytherapy. Conclusion The causes of resistant hypertension in uncontrolled patients mostly due to renal causes such as chronic renal failure and nephritic syndrome and rapid progressive glomerulonephritis