MEDIX, God. 24 Br. 130/131  •  Pregledni članak  •  Interna medicina HR ENG

Predhipertenzija u djece i adolescenataPrehypertension in children and adolescents

Vesna Herceg-Čavrak, Bernardica Valent Morić

Blago povišenim vrijednostima arterijskoga tlaka, predhipertenziji, u dječjoj i adolescentskoj dobi, nerijetko se ne posvećuje osobita pozornost. Dva su bitna problema koja vežemo uz predhipertenziju u djece i adolescenata – rizik progresije u hipertenziju i prisutno oštećenje ciljnih organa. Longitudinalna istraživanja potvrdila su prosljeđivanje arterijskoga tlaka iz djetinjstva u odraslu dob. Predhipertenzija u djece i adolescenata definirana je vrijednostima sistoličkoga i/ili dijastoličkoga tlaka većim od 90. percentile, ali manjim od 95. percentile za dob, spol i tjelesnu visinu, a za adolescente od 16 godina i starije,vrijednosti su kao za odrasle 130–139/85–89 mmHg. Prevalencija predhipertenzije u djece i adolescenata je od 4 do 27% u ovisnosti o načinu prikupljanja podataka, dobi i spolu. Rizik za progresiju predhipertenzije u hipertenziju veći je nego u normotenzivnih, te godišnja incidencija hipertenzije u djece s predhipertenzijom iznosi 1,1% do 6,6%. Osim rizika za razvoj hipertenzije, u djece s predhipertenzijom nalazimo već prisutno oštećenje ciljnih organa – hipertrofiju lijeve klijetke, dijastoličku disfunkciju, veću debljinu intime medije te povećanu krutost arterija, što ima kliničko značenje za razvoj kardiovaskularnih bolesti u odrasloj dobi. Pravodobna detekcija predhipertenzije i promjena načina života toj bi djeci donijela najviše koristi u prevenciji kardiovaskularnih bolesti odrasle dobi.

Ključne riječi:
djeca; hipertenzija; predhipertenzija

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 24 Br. 130/131

It is rather common that insufficient attention is being paid to slightly elevated blood pressure levels in children and adolescents. There are two important problems associated with prehypertension in children and adolescents - the risk of progression to hypertension and the damage of target organs. Longitudinal studies have confirmed that the arterial blood pressure from childhood and adolescence continues into adulthood. Prehypertension in children and adolescents is defined by the values of systolic and/or diastolic pressure higher than the 90th percentile but lower than the 95th percentile for age, gender and body height. For adolescents aged 16 years and older, the hypertension marginal values are the same as for adults - 130-139 / 85-89 mmHg. Prevalence of prehypertension is 4-27% depending on the data collecting method, as well as patient age and gender. The risk of progression of prehypertension to hypertension is higher than in normotensive individuals, an annual incidence of hypertension in children with prehypertension being 1.1% to 6.6%. In addition to the risk of hypertension, prehypertensive children suffer from already damaged target organs - left ventricular hypertrophy, diastolic dysfunction, increased intima-media thickness and increased arterial stiffness, all having a clinical relevance for the development of cardiovascular diseases in adulthood. Timely detection of prehypertension and lifestyle changes would bring most benefit to these children as it relates to the prevention of cardiovascular diseases in adult age.

Key words:
children; hypertension; prehypertension