Approach to the treatment of hypertension in children

Childhood hypertension necessitates a careful approach to diagnosis and a tailored approach to management. Hypertension in children should not be considered a rare condition. The diagnosis of hypertension must be assessed carefully, with attention to age, sex, and height standards. Also, careful attention should be given to the methods used to measure blood pressure. Once the diagnosis is made and the underlying etiologies have been evaluated and managed as necessary, both nonpharmacologic and pharmacologic approaches to treatment have been used. Nonpharmacologic approaches, especially weight reduction and increased physical activity, are beneficial. If pharmacologic approaches are needed, the goal of therapy should be to reduce blood pressure below the 95th percentile in the easiest, most effective manner that causes the fewest side effects. Angiotensinconverting enzyme inhibitors, calcium-channel blockers, α and β blockers, and diuretics have all been used in children. Newer antihypertensives, such as angiotensin receptor blockers, are now being tested.