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Hypertension in pediatric
- 1. Supervised by Dr.Shatha Done by Haneen ayad Tuka essam
- 2. Subjects Definition Staging Which children should get their blood pressure checked? How to measure blood pressure in children ? Choose appropriate cuff size Etiology Acutehypertension Condition associated with chronic hypertension
- 3. Hypertension is defined as blood pressure greater than the 95th percentile for age , gender and height at least three different occasions Blood pressure percentile (%) Blood pressure category < 90thNormal 90th to 95thPrehypertension 95th to (99th + 5 mm Hg )Stage 1 hypertension > 99th +5 mm HgStage 2 hypertension If 90th % is 120/80 ,, use 120/80 as the lower limit
- 4. Which children should get their blood pressure checked? Accurate blood pressure measurements should be part of the routine annual physical examination of all children 3 years or older Younger than 3 years old ,.. Prematurity Hx. Of low birth weight and NICU stay Presence of congenital heart , kidney and genitourinary abnormalities Family history of congenital kidney disease Recurrent UTI , hematuria , proteinuria Transplant of solid organ or bone marrow Malignancy Taking medications increase blood pressure (steroids , NSAID , decongestants , ….)
- 5. How to measure blood pressure in children ? The child should be calm and free of anxiety The child should have been setting quietly for 5 minute The child should be setting with back supported , both legs on the floor and right cubital fossa supported at the heart level
- 6. Choose appropriate cuff size
- 7. The cuff width should be cover 70% of distance between acromion and olecranon The cuff bladder length should be 80-100% of arm circumference and cuff bladder width should be at least 40% of arm circumference at midpoint between acromion-olecranon distance
- 9. Then correlate blood pressure to the age , weight and height
- 11. EITOLOGY
- 13. EITOLOGY
- 19. Managemen t
- 22. DIAGNOSTIC STUDIES Evaluation of children with confirmed HTN include: • 1 . Baseline etiologic assessment 2. Focused studies based on clinical suspicion 3. Assessment for target organ damage 4. Assessment for other cardiovascular risk factor
- 30. is a condition characterized by varying degrees of headache, nausea, vomiting, visual disturbances, focal neurologic deficit, and seizures in the setting of severe systemic hypertension that is relatively acute in onset. The degree of hypertension varies, but systolic pressure greater than 250 mm Hg and diastolic pressure greater than 150 mm Hg are commonly encountered. It can be seen in patients with acute elevation of blood pressure related to nephritis or eclampsia . alternatively, it may be superimposed on chronic, untreated, or inadequately treated essential hypertension (1, 2) Clinical findings typically resolve with adequate treatment of the hypertension; permanent deficits are seen in those cases complicated by frank infarction or hemorrhage
- 31. PROGNOS IS Prognosis depend on underlying etiology and BP Control. Essential HTN , when present in adolescent is Usually NOT associated with morbidity at presentation . IF left untreated even ASYMPTOMATIC HTN may increase risk for CVS , CNS and RENAL morbidity.
- 32. Nelson Essentials Of Pediatrics,7th Edition, Karen J. Marcdante, MD, Robert M. Kliegman, MD. Medscape.com Referenc es