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Hypertension in Children and Adolescents pp 177–189Cite as

The Heart in Childhood Hypertension

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Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

Chronic elevated blood pressure leads to structural and functional changes in the heart, also known as hypertensive heart disease. Increased left ventricular wall stress causes left ventricular hypertrophy seen in about one third of hypertensive children. Furthermore, abnormal left ventricular diastolic filling is also commonly seen in children and adolescents with primary hypertension. The renin-angiotensin-aldosterone system plays a major role in the pathophysiology of hypertensive heart disease.

Echocardiography is the method of choice to look for cardiac end-organ damage in all hypertensive children and adolescents at diagnosis and in selected patients during follow-up. However, it is challenging that we still lack standardization and a consensus definition for left ventricular indexing to body size and for left ventricular hypertrophy in these age groups.

Both left ventricular hypertrophy and abnormal left ventricular diastolic filling are associated with non-hemodynamic factors like obesity, insulin resistance, raised plasma glucose, and ethnicity. This emphasizes the importance of a holistic approach in the management of a hypertensive child or adolescent.

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Authors and Affiliations

  1. Department of Pediatrics, Haukeland University Hospital, Bergen, Norway

    Asle Hirth

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  1. Head of Pediatrics Department, Hospital General Universitario Valencia, Valencia, Spain

    Empar Lurbe

  2. Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany

    Elke Wühl

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Hirth, A. (2019). The Heart in Childhood Hypertension. In: Lurbe, E., Wühl, E. (eds) Hypertension in Children and Adolescents. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-18167-3_11

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  • DOI: https://doi.org/10.1007/978-3-030-18167-3_11

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