Hypertension in Children and Adolescents [antikvár]

PrefaceHypertension in the young must be studied in the young. The following statements indicate why the study of hypertension in children is necessary and will provide information not obtainable in the adult.1.Antecedents of essential hypertension in adults must be looked for in the young. Investigation of the young will make it possible to seek markers and risk factors for the development of hypertension.2.There is evidence that essential hypertension is a hereditary disorder. The genetics of the disorder are best studied at the earliest stage of life, before some environmental forces that may affect blood pressure are superimposed.3.Since essential hypertension is asymptomatic in its earliest stages, vascular changes may have already occurred at the time of detection. Prevention of complications may be possible if children with high blood pressure are studied.4.Prenatal influences on blood pressure can best be investigated in the newborn and very young infant.5.Some forms of hypertension are more frequently diagnosed in the child than in the adult, for example, high blood pressure occurring with acute glomerulonephritis and congenital adrenal hyperplasia. Therefore, pediatric groups may provide the necessary study populations.6.Some forms of hypertension are reversible in the child but not in the adult. "Dexamethasone-suppressible hyperaldosteronism" is associated with high blood pressure in children and in adults. This disorder has recently been described in three children and in their mother. Although the children's blood pressure levels decreased promptly with dexamethasone treatment, the mother remained hypertensive. Thus, failure to diagnose the syndrome in childhood, when hypertension responds to treatment, penalizes the adults as well as the child. Further research is required to determine why the child responds to treatment while the adult does not.7.The long-term pharmacologic benefits and risks of treating children with hypertension are not known. Studies must be conducted to determine the effect of antihypertensive drugs on growth and puberty.This volume touches on all these aspects and brings the reader up to date on the current status of hypertension in the developmental age.Understanding the pathophysiology of childhood hypertension oflFers the best hope of reversing the hypertensive process before severe vascular complications intervene. Thus, research into childhood hypertension constitutes a form of preventive medicine to which this book, by summarizing the present knowledge on the subject, brings a valuable contribution.The Editors