By ULY CLINIC staff
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Hypertension in Children
Systolic and diastolic blood pressure above the 95th percentile for age and sex.
Clinical presentation
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Most patients are asymptomatic , however these symptoms might be present
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Headache
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Vomiting
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Shortness of breathing
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Chest pain
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Fast breathing
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Palpitation
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Diagnostic Criteria
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Elevated BP for age and sex taken at more than one ocation
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Presence dysmorphic features eg. Moon facies, ambiguous or virilised genitalia.
Investigations
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Chest X Ray
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ECG and Echocardiogram
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Renal ultrasound
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24 hour urine for catecholamines and metanephrines
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Urinalysis
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Serum electrolytes
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Serum creatinine and BUN
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Uric acid and cholesterol
Treatment
Non Pharmacological treatment
Mild hypertension can be managed without medication.
Weight reduction (assuming the patient is obese), increased exercise and some degree of sodium restriction.
Pharmacological treatment:
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Nifedipine PO 0.25 mg/kg 8 hourly OR
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Hydralazine PO 0.25 mg/kg 12 hourly in combination with beta blockers such as Propranolol PO 0.5 mg/kg 12 hourly OR
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Atenolol PO 0.2 mg/kg once a day OR
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Captopril PO 1mg/kg 12 hourly OR
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Enalapril 0.1mg/kg once a day OR
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Nifedipine sublingual 0.2mg/kg 12 hourly
Note:
Hypertension in children in most cases is secondary hypertension, refer to the next level facility with adequate expertise and facilities
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Last updated on 26.09.2020
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References
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​Tanzanian Standard treatment guideline for children 2017 edition page 110
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Cincinnati Children's. Hypertension in children. https://www.cincinnatichildrens.org/health/h/hypertension. Accessed on September 26, 2020
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Mediscape. Paediatric hypertension. https://emedicine.medscape.com/article/889877-overview. Accessed on September 26, 2020
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Mayo clinic. High blood pressure in children. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure-in-children/symptoms-causes/syc-20373440. Accessed on September 26, 2020