MJ Dillon

Abstract

The pattern of childhood hypertension is changing with a significant increase in the numbers of children with primary hypertension occurring in conjunction with childhood obesity. The phasing out of mercury sphygmomanometry, the problems of identifying an alternative method of blood pressure measurement, the increasing use of ambulatory blood pressure monitoring, the emphasis on systolic hypertension and the recognition of white coat hypertension are modifying the views of what is and what is not hypertension in childhood. Newer investigative techniques and more sophisticated therapeutic manoeuvres, including interventional radiology, are influencing the handling of secondary hypertension and there is an increasing recognition that monogenic forms of hypertension affect children. Anti-hypertensive drug trials are now including children with hopefully in future the availability of newer therapeutic agents for paediatric use.