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Chapter-22 Hypertension

BOOK TITLE: CDiC Textbook of Pediatric Diabetes

Author
1. Kalra Sanjay
2. Sahay Rakesh
3. Dhingra Mudita
ISBN
9789352700868
DOI
10.5005/jp/books/14155_23
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. Bharti Hospital, Karnal, Haryana, India, Bharti Hospital and B.R.I.D.E., Karnal 132 001, Haryana, India, Bharti Hospital and BRIDE Karnal; Indian J Endocrinology Metabolism, Bharti Hospital, Karnal, Haryana, India, Bharti Hospital, Karnal-132001, Haryana, India, Indian J Endocrinology and Metabolism; J of Social Health in Diabetes (JoSH Diabetes), Bharti Hospital and BRIDE, Karnal, Haryana, India, Bharti Hospital and BRIDE, Karnal, Haryana, India
2. Osmania Medical College and Osmania General Hospital; Mediciti Hospital, Hyderabad, Andhra Pradesh, India; Endocrine Society of India; AP Chapter of RSSDI; Journal of Academy of Medical Sciences; Indian Journal of Endocrinology and Metabolism, Osmania Medical College and Osmania General Hospital, Hyderabad, Telangana, India, Osmania General Hospital, Hyderabad, Telangana, India, Osmania Medical College and Hospital, Hyderabad, Telangana, India
3. Rotary Hospital, Ambala, Haryana, India, Radhakishan Hospital, Kurukshetra, Haryana, India, Radhakishan Hospital, Kurukshetra, Haryana, India
Chapter keywords
Hypertension, T1DM, SBP, DBP, mean arterial pressure, MAP, ABPM, nonpharmacological intervention, nephropathy

Abstract

This chapter focuses on hypertension in children with diabetes, its evaluation, nonpharmacological therapy, and pharmacological management. Diabetes in children is a multifaceted disease, which needs a comprehensive and team effort, rather than glucocentric approach for evaluation and management. Hypertension, in children, is defined as an average systolic blood pressure (SBP) and/or diastolic BP (DBP) that is greater than or equal to the 95th percentile for sex, age, and height on three separate occasions. Clinical evaluation in children includes a detailed history taking and comprehensive physical examination. Ambulatory blood pressure monitoring (ABPM), renal function tests, plasma renin activity, renovascular imaging, echocardiography, plasma and urine steroid, and catecholamine levels are important investigations tools for hypertension. An emphasis on healthy lifestyle, weight management, and cardiovascular risk factor mitigation must be practiced. Appropriate, and timely, use of antihypertensive therapy, aiming to control BP to less than 90th percentile, relieve symptoms, and prevent progression of nephropathy, is equally important.

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