(1) Hypertension in children can be primary or secondary, and is defined based on BP percentiles adjusted for age, sex, and height.
(2) The I3C Consortium found that childhood BP is predictive of adult BP, and elevated BP in childhood can lead to increased risk of cardiovascular issues like LVH and cIMT thickening in adulthood.
(3) Evaluation of hypertension in children includes assessing for secondary causes, target organ damage, and cardiovascular risks. Treatment involves non-pharmacological lifestyle changes and may include pharmacological therapy depending on the severity of hypertension.
childhood hypertension is unique presentation by Dr. Hemraj Soni,
very compressive, complied,upgraded, presentation......will definative helpfull for paediatrician n resident doctor............
diagnosing hypertension in children
work up for increased blood pressure
guide line for controling hypertension in pediatrics
treatment of hypertension
hypertensive crisis/emergency
childhood hypertension is unique presentation by Dr. Hemraj Soni,
very compressive, complied,upgraded, presentation......will definative helpfull for paediatrician n resident doctor............
diagnosing hypertension in children
work up for increased blood pressure
guide line for controling hypertension in pediatrics
treatment of hypertension
hypertensive crisis/emergency
This presentation is a simplified version of the various types of cardiac arrythmias seen in pediatric age groups. We have discussed supraventricular tachycarsias and prolonged QT syndrome in details here. Hope everyone finds it useful.
This presentation is a simplified version of the various types of cardiac arrythmias seen in pediatric age groups. We have discussed supraventricular tachycarsias and prolonged QT syndrome in details here. Hope everyone finds it useful.
This presentation focus on the accurate method of BP measurement as well as the presentation of the latest clinical trials of hypertension management and their impact on recent guidelies
This lecture presents the 1-Updated recommendations regarding definition and proper diagnosis of HTN. 2-Updated guidelines for threshold of BP to start treatment and targets of treatment. 3- Updated recommendations on CV risk assessment and management. 4-Hypertension and comorbidities: updated guidelines
HypertensioN, The Silent Killer, Hypertension is a common disease that is simply defined as persistent elevated arterial blood pressure (BP).
Hypertension (HTN), also known as high blood pressure (BP), affects millions of people. High blood pressure is defined as BP ≥140/90 millimeters of mercury (mmHg). As per JNC 8
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
2. • AHA /AAP guidelines 2017
• The international childhood cardiovascular cohort (i3c)
consortium
• 2016 European society for hypertension guidelines for high BP
in children and adolescents.
8. 2 important questions:
(1) What is the rationale for identification and treatment of
hypertension in children ?
(2) How is hypertension in children defined and diagnosed?
In addition, knowledge gaps and research priorities and
recommendations for practice
9. Rationale for identification and treatment
International Childhood Cardiovascular Cohort (I3c) Consortium was
initiated in 2002 and consists of 7 large cohorts in the United
States(5), Finland(1), and Australia(1), brought together to link
childhood cardiovascular risk factors to adults disease
Twelve-thousand cohort members .The majority are now in their
twenties and thirties
10. I3c consortium key evidences
1) Childhood BP, whether normal or high, is strongly predictive of adult
BP, reinforcing the importance of early recognition.
2) LVH, which is strongly associated with hypertension in adults, is an
established, independent risk factor for cardiovascular events.
11. I3c consortium key evidences
3) Elevated BP that persisted from childhood into adulthood was
associated with increased cIMT.
4) Microalbuminuria is a powerful predictor of both renal insufficiency
and cardiovascular morbidity and mortality in adults. The prevalence
of microalbuminuria among children diagnosed with hypertension is
estimated to be 20%.
12. Forthcoming evidence from the i3c consortium
The I3C Consortium has recently received funding for a study to
measure cardiovascular events among all 7 cohorts beginning in 2015
The study, to be completed in 2018, will provide extremely valuable
information, including an estimate of the long- term risk, if any,
conferred by pediatric hypertension, including cardiovascular events,
and potential validation of current BP standards in relation to
cardiovascular events.
13. Indian scenario
The application of international reference to Indian children that differ in various
demographic factors, may not be valid
Higher diastolic pressures for both sexes than international standard across all age
groups.
Higher blood pressure values in Indian population are of considerable public
health significance.
Blood Pressure Distribution in Indian Children, Indian Paediatrics Sep 2009
From the Departments of Pediatric Cardiology and *Biostatistics, Amrita Institute of Medical Sciences and Research Centre,
Kochi, India.
14. Diagnosis
Hypertension in adults is persistent systolic BP ≥130(140) mm
Hg OR diastolic BP ≥80(90) mm Hg.
This is based on outcomes data, such as cardiovascular
morbidity and mortality---Not available for children.
Because BP is approximately normally distributed, they
recommended a threshold of systolic and diastolic BP that is 2
SDs above the mean, or roughly the 95th percentile.
15. Approach used with children defined according to normative
percentiles of BP averaged over 3 occasions.
These percentiles are in turn adjusted for children’s age, sex,
and height percentiles
Whichever of systolic or diastolic BP percentile is higher
defines the BP category
16. • Based on BP categories
• Associated conditions
20. So using these new tables excluding obese children from
pevious tables more children will be labeled as
hypertensive
21. • Based on the 90th
percentile BP for age
and sex at the 5th
percentile of height.
• Which gives the
values in the table a
NPV of >99%.
22. MEASUREMENT
METHODS—AUSCULTATION/ OSCILLOMETRIC DEVICES/ INVASIVE
CUFF SIZE—
OTHER REQUIREMENTS
•Cuff inflated 20 to 30 mmHg above the anticipated systolic BP and
then deflated slowly at a rate of 2 to 3 mmHg per heartbeat
•Prior to BP measurement, stimulant drugs or food should be avoided.
•Measured after five minutes of rest. The child should be seated with
his/her back and feet in a supported position. In infants, -supine
position.
•The right arm is preferred
23. METHODS
•Auscultation remains the recommended method of BP measurement in
children, under most circumstances.
•SBP is determined by the onset of the “tapping” Korotkoff sounds (K1).
fifth Korotkoff sound (K5), or the disappearance of Korotkoff sounds, as the
definition of DBP.
In some children, Korotkoff sounds can be heard to 0 mmHg. Under these
circum- stances, the BP measurement should be repeated with less pressure
on the head of the stethoscope.
Only if the very low K5 persists should K4 (muffling of the sounds) be
recorded as the DBP.
24. Cuff size
• Appropriate cuff size is a cuff with an inflatable bladder width that
is at least 40 percent of the arm circumference at a point midway
between the olecranon and the acromion.
• For such a cuff to be optimal for an arm, the cuff bladder length
should cover 80–100 percent of the circumference of the arm
• Such a requirement demands that the bladder width- to-length ratio
be at least 1:2
27. OSCILLOMETRY VS AUSCULTATION
OSCILLOMETRY
• MAP is determined SBP AND
DBP are calculated
• Calculation formulas are
different for different machines
• Easy to use in infants and
neonates where auscultation is
difficult
• Easier to use where continuous
/repeated monitoring
needed/busy OPD
• Overestimates
• normative data emerging
AUSCULTATION
• SBP and DBP are measured
• Inter-observer variation
• Better predictor of TOD
• Normative data based on it
28. ABPM
•ABPM is useful in reducing over diagnosis of hypertension.
•ABPM is also extremely useful in identifying secondary
hypertension.
•Daytime diastolic BP load >25% plus nocturnal systolic load >50%
have been shown to have 92% specificity for predicting secondary
hypertension.
•In addition, evidence is emerging that ABPM is more useful than
clinic BP in predicting target organ damage.
29. A sufficient number of valid BP recordings are needed for a study to
be considered interpretable.
• Minimum of 1 reading per hour, including during sleep
• At least 40 to 50 readings for a full 24-hour report
The AHA has proposed standards for abnormal ABPM values based
on mean ambulatory systolic BP >95th percentile, combined with
systolic load of 25% to 50% (the percent of systolic measurements
>95th percentile over the entire 24-hour period
30. ABPM carried out over a 24-hour period—portable device attached to
the (non dominant) arm, at 15- to 30-minute intervals during waking
times and every 20 to 60 minutes during sleep. Both systolic BP and
diastolic BP normally decline at night.
BP load is then calculated as the proportion of readings above a
threshold (usually the pediatric 95th percentile).
Dipping is defined as the percentage drop from mean daytime to mean
night-time levels.
31.
32.
33. Limitations of ABPM
• Population-based ABPM values are different
than clinic-based measurements.
• Normative ABPM available -but have been
derived from white German children only,
rather than form more diverse population
37. Differentiating Primary and Secondary HT
Primary hypertension
• Adolescents
• Usually stage 1
• Overweight /obese
• Positive family history
• Usually asymtomatic
Secondary hypertension
• Prepubertal
• Usually stage 2
• Diastolic / nocturnal
• May be positive
• Symptoms of underlying
disorder
38. • Based upon the initial history, physical
examination, and laboratory evaluation, --
establish whether the HTN is primary or
secondary.
• Further evaluation --to identify any potentially
reversible cause of secondary HTN.
40. Non Pharmacologic Therapy
Recommended for all pts with HT
• Wt reduction in obese pts.
• Regular exercise
• Dietery modification
• Preventing dyslipidemia, avoiding smoking,
alchohol, caffeine , energy drinks
2017 AAP guidelines recommend that
dietary sodium be restricted to
<2300 mg/day. In younger children, the
normal requirement of sodium is
between 2 to 3 mEq/kg per day.
moderate to vigorous activity
for 30 to 60 minutes sessions
for at least 3 to 5 days per
week
41. Pharmacologic therapy
●Symptomatic HTN
●Stage 2 HTN.
●Stage 1 HTN without any evidence of end-organ damage and that persists
despite a trial of four to six months of non-pharmacologic therapy.
●Hypertensive end-organ damage
●Any stage of HTN or high BP for patients with chronic kidney disease (CKD).
●Any stage of HTN for patients with DM
42. Target BP-AAP 2017 guidelines
• Below the 90th percentile or <130/80 in
adolescents (13 years or older)
• CKD -goal of mean arterial BP <50th percentile
based on 24-hour ambulatory blood pressure
monitoring (ABPM)
43. Elevated BP-
Nonpharmacologic therapy-BP to below the 90th percentile
or <130/80 mmHg in adolescents who are 13 years or older.
Stage 1 primary HTN without evidence of end-organ damage or
CVD risk factors,
Nonpharmacologic therapy -target goals are not met within
four to six months after initial therapy (ie, BP below the
90th percentile), pharmacologic therapy is initiated.
44. Stage 1 HTN
Symptomatic or have evidence of end-organ damage or CVD risk
factors, both non-pharmacologic and pharmacologic therapy are
started.
Stage 2 HTN
Both nonpharmacologic and pharmacologic therapy. Patients with
stage 2 HTN and neurologic symptoms including headache, mental
status changes, and neurologic findings should be emergently
evaluated and treated.
Secondary HTN
Therapy directed to the underlying cause, if possible. If the
underlying cause cannot be corrected so that HTN is abolished,
pharmacologic and non-pharmacologic therapy are initiated.
45. Choice of initial drug
• Underlying cause of HTN
• Concurrent disorders
• And the preference and experience of the responsible
clinician
46. Primary HTN
• ACE inhibitor or ARB-except for sexually active females.
• If the target BP goal is not met with the maximum
allowable dose of the initial medication (ACE inhibitor or
ARB), add a thiazide diuretic to the drug regimen.
For sexually active females -CCB be used as the initial
antihypertensive agent
Renovascular Disease-CCB be used as the initial
antihypertensive agent
CKD/DM-ACE inhibitors be used as the initial
antihypertensive agent ARBs are a reasonable alternative.
51. Sports participation
Elevated BP
• May participate in competitive sports.
• Ongoing management includes
nonpharmacologic measures (weight
management, well balanced diet, and
daily physical activity)
• Monitoring of BP every six months.
52. Sports participation
Stage 1 HTN and no evidence of end-organ
injury
• May participate in competitive sports.
• BP checked within one to two weeks after initiation
of competitive sports or sooner if symptomatic.
• Referral to subspecialists with expertise in managing
children with HTN is warranted for children who are
symptomatic, have LVH or concomitant heart disease,
or have persistently elevated BP on two additional
occasions.
53.
54. Stage 2 HTN
• Restricted from high-static sports even if there is no
evidence of end-organ injury.
• These would include sports classified as IIIA to IIIC
• Children with stage 2 HTN, once treated and
documented to be normotensive, may be allowed to
participate in these sports with ongoing monitoring.
55. Summarize
• Pre-hypertension is now elevated BP
• Normative BP tables based on normal-weight , non obese
children
• A simplified screening table for identifying BPs needing
further evaluation
• A simplified BP classification in adolescents ≥13 years of
age
56. • More limited recommendation for screening BP
measurements only at preventive care visits.
• Streamlined recommendations on the initial evaluation and
management of abnormal BPs
• An expanded role for ambulatory BP monitoring
• Recommendations on when to perform echocardiography in
the evaluation of newly diagnosed hypertensive pediatric
patients
• Pharmacological and non pharmacological treatments
Editor's Notes
These charts are based on CDC growth charts for height estimation,
in repeated measures of BP for consistency and comparison with standard tables and because of the possibility of coarctation of the aorta, which might lead to false (low) readings in the left arm
•Obese – BMI ≥95th percentile for age and sex--DYSLIPIDEMIA- total cholesterol >200/ LDL>130, TG.>130=<10 yr ,, 10 yr- 100/ HDL--<40 LVH-LV wall thickness z score >2
In our practice, we begin dietary salt modification with a no-added-salt diet. This also includes a reduction in or elimination of foods containing large amounts of salt (eg, potato chips, pretzels, processed foods).
DASH diet with a high intake of potassium and low intake of fat and sodium is recommended for children with high BP
Athletes heart
Medicines which are prescribed may be a banned substance