Hypertension in Children
David Goldring MD1
Antonio Hernandez MD1
1 Edward Mallinckrodt Department of Pediatrics, Division of Cardiology, Washington University School of Medicine, and St Louis Children's Hospital, St Louis
The pathogenesis of primary hypertension remains unknown despite extensive investigative contributions. Evidence is mounting that the disease may have its inception in childhood or possibly in infancy. What is needed are long-term longitudinal studies to determine whether the child with primary hypertension eventually becomes the adult hypertensive. A method for the identification of the hypertensive either by specific chemical or physiologic characteristics is very much needed.
Nonpharmacologic therapeutic intervention needs careful evaluation, especially in the pediatric patient, to determine whether the disease can be arrested. A thorough study of pediatric patients with primary hypertension should be strongly encouraged. It may be that the solution to the complex puzzle of primary hypertension may have a higher probability of being solved at the inception of the disease in infancy or childhood rather than in the later irreversible stage in adulthood.
