Physiology and treatment of hypertension

Secondary hypertension in children is a rare but important cause of morbidity and mortality. Whilst severe hypertension can be symptomatic more often it is not and blood pressure measurement is mandatory in all children at risk. The vast majority of childhood secondary hypertension is related to renal disease and treatment is with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Primary or essential hypertension in children is being increasingly recognised. Lifestyle factors and obesity play a significant role. If long-term morbidity is to be avoided early detection assessment and intervention is required.