Question

Hypertension in children: Management.

Hint:

A combination of lifestyle changes and medications is often required for effective management of hypertension in children, especially in cases with secondary causes.

Answer 1

Step 1: General Approach to Management.
Management of hypertension in children involves lifestyle changes, pharmacological therapy, and treatment of underlying causes.
Step 2: Non-pharmacological Management.
(1) Lifestyle Modifications:
- Diet: Reducing sodium intake, promoting a balanced diet, and ensuring adequate potassium intake.
- Exercise: Encouraging regular physical activity to reduce weight and improve cardiovascular health.
- Weight Reduction: In obese children, reducing weight can have a significant impact on blood pressure.
- Limiting Caffeine and Alcohol Intake: In adolescents, reducing the intake of stimulants and alcohol.
Step 3: Pharmacological Management.
(1) Angiotensin-Converting Enzyme (ACE) Inhibitors: Commonly used to lower blood pressure and protect kidney function.
(2) Angiotensin Receptor Blockers (ARBs): Another class of drugs used for controlling blood pressure.
(3) Calcium Channel Blockers (CCBs): Often used in cases where ACE inhibitors are not sufficient or tolerated.
(4) Diuretics: To reduce fluid volume and control blood pressure, especially in cases with fluid retention.
(5) Beta-blockers: May be used for children with secondary hypertension or those with heart involvement.
Step 4: Management of Secondary Hypertension.
If secondary causes are identified, treatment should focus on managing the underlying condition (e.g., surgery for coarctation of the aorta, pharmacological treatment for endocrine disorders).