Issues in the pharmacologic management of primary hypertension in adolescence

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Hypertension may occur in as many as 12% of adolescents and is usually of primary origin. There is an age-related increase of the blood pressure, making it difficult to define the limits of normal. True hypertension can be defined as blood pressure exceeding 140 90 mmHg regardless of age. Borderline blood pressure is said to exist when the blood pressure is above the 90th percentile for age. Blood pressure can be lowered with a wide variety of drugs, and adolescents are most often prescribed adult doses. There are specific concerns about the drugs' side effects in adolescents, particularly effects on growth and development, cognitive function, and metabolism. Diuretics are not the best first choice for therapy because of their metabolic effects. Cardiac hypertrophy and the morbidity of sustained hypertension are reduced by sympathetic inhibitors. Beta-blockers are the best currently available choice, although newer alpha-blocking agents may have some advantages. Even borderline pressure has been associated with evidence of cardiac hypertrophy, and there is substantial evidence that the adolescents with the highest blood pressures, even if still within normal limits, have the highest likelihood of developing sustained hypertension as adults. Yet there is no data establishing a beneficial effect on long-term risk of early treatment with drugs. For these reasons, nonpharmacologic intervention and close follow up are preferred as treatment for borderline blood pressure.

Original languageEnglish (US)
Pages (from-to)92-104
Number of pages13
JournalJournal of Adolescent Health Care
Volume8
Issue number1
DOIs
StatePublished - 1987

Fingerprint

Blood Pressure
Hypertension
Cardiomegaly
Drug-Related Side Effects and Adverse Reactions
Growth and Development
Diuretics
Pharmaceutical Preparations
Cognition
Therapeutics
Morbidity
Pressure

Keywords

  • Antihypertensive agents
  • Hypertension
  • Risk factors
  • Side Effects

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health

Cite this

Issues in the pharmacologic management of primary hypertension in adolescence. / Reichgott, Michael J.

In: Journal of Adolescent Health Care, Vol. 8, No. 1, 1987, p. 92-104.

Research output: Contribution to journalArticle

@article{f99a91bab01149e9968b8be5a33fc8bd,
title = "Issues in the pharmacologic management of primary hypertension in adolescence",
abstract = "Hypertension may occur in as many as 12{\%} of adolescents and is usually of primary origin. There is an age-related increase of the blood pressure, making it difficult to define the limits of normal. True hypertension can be defined as blood pressure exceeding 140 90 mmHg regardless of age. Borderline blood pressure is said to exist when the blood pressure is above the 90th percentile for age. Blood pressure can be lowered with a wide variety of drugs, and adolescents are most often prescribed adult doses. There are specific concerns about the drugs' side effects in adolescents, particularly effects on growth and development, cognitive function, and metabolism. Diuretics are not the best first choice for therapy because of their metabolic effects. Cardiac hypertrophy and the morbidity of sustained hypertension are reduced by sympathetic inhibitors. Beta-blockers are the best currently available choice, although newer alpha-blocking agents may have some advantages. Even borderline pressure has been associated with evidence of cardiac hypertrophy, and there is substantial evidence that the adolescents with the highest blood pressures, even if still within normal limits, have the highest likelihood of developing sustained hypertension as adults. Yet there is no data establishing a beneficial effect on long-term risk of early treatment with drugs. For these reasons, nonpharmacologic intervention and close follow up are preferred as treatment for borderline blood pressure.",
keywords = "Antihypertensive agents, Hypertension, Risk factors, Side Effects",
author = "Reichgott, {Michael J.}",
year = "1987",
doi = "10.1016/0197-0070(87)90250-6",
language = "English (US)",
volume = "8",
pages = "92--104",
journal = "Journal of Adolescent Health",
issn = "1054-139X",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - Issues in the pharmacologic management of primary hypertension in adolescence

AU - Reichgott, Michael J.

PY - 1987

Y1 - 1987

N2 - Hypertension may occur in as many as 12% of adolescents and is usually of primary origin. There is an age-related increase of the blood pressure, making it difficult to define the limits of normal. True hypertension can be defined as blood pressure exceeding 140 90 mmHg regardless of age. Borderline blood pressure is said to exist when the blood pressure is above the 90th percentile for age. Blood pressure can be lowered with a wide variety of drugs, and adolescents are most often prescribed adult doses. There are specific concerns about the drugs' side effects in adolescents, particularly effects on growth and development, cognitive function, and metabolism. Diuretics are not the best first choice for therapy because of their metabolic effects. Cardiac hypertrophy and the morbidity of sustained hypertension are reduced by sympathetic inhibitors. Beta-blockers are the best currently available choice, although newer alpha-blocking agents may have some advantages. Even borderline pressure has been associated with evidence of cardiac hypertrophy, and there is substantial evidence that the adolescents with the highest blood pressures, even if still within normal limits, have the highest likelihood of developing sustained hypertension as adults. Yet there is no data establishing a beneficial effect on long-term risk of early treatment with drugs. For these reasons, nonpharmacologic intervention and close follow up are preferred as treatment for borderline blood pressure.

AB - Hypertension may occur in as many as 12% of adolescents and is usually of primary origin. There is an age-related increase of the blood pressure, making it difficult to define the limits of normal. True hypertension can be defined as blood pressure exceeding 140 90 mmHg regardless of age. Borderline blood pressure is said to exist when the blood pressure is above the 90th percentile for age. Blood pressure can be lowered with a wide variety of drugs, and adolescents are most often prescribed adult doses. There are specific concerns about the drugs' side effects in adolescents, particularly effects on growth and development, cognitive function, and metabolism. Diuretics are not the best first choice for therapy because of their metabolic effects. Cardiac hypertrophy and the morbidity of sustained hypertension are reduced by sympathetic inhibitors. Beta-blockers are the best currently available choice, although newer alpha-blocking agents may have some advantages. Even borderline pressure has been associated with evidence of cardiac hypertrophy, and there is substantial evidence that the adolescents with the highest blood pressures, even if still within normal limits, have the highest likelihood of developing sustained hypertension as adults. Yet there is no data establishing a beneficial effect on long-term risk of early treatment with drugs. For these reasons, nonpharmacologic intervention and close follow up are preferred as treatment for borderline blood pressure.

KW - Antihypertensive agents

KW - Hypertension

KW - Risk factors

KW - Side Effects

UR - http://www.scopus.com/inward/record.url?scp=0023067163&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023067163&partnerID=8YFLogxK

U2 - 10.1016/0197-0070(87)90250-6

DO - 10.1016/0197-0070(87)90250-6

M3 - Article

VL - 8

SP - 92

EP - 104

JO - Journal of Adolescent Health

JF - Journal of Adolescent Health

SN - 1054-139X

IS - 1

ER -