Secondary forms of hypertension in children: Overview

Blood pressure is a very important vital sign providing significant information into the health of a child. Sustained elevated readings require further evaluation to determine if a child has primary or secondary hypertension. Secondary forms of hypertension are more common in younger children than in adolescents, and often, in those presenting with very elevated blood pressure readings. After careful clinical evaluation, most causes of secondary hypertension in children are readily identifiable. The causes for secondary hypertension are noted in this chapter and discussed in depth elsewhere in this text. In this chapter, we also discuss the clinical challenge of trying to identify a secondary cause for hypertension in a child or adolescent when none is obvious. Improved methods for predicting secondary hypertension in asymptomatic children are needed to guide cost-effective work-up and would also reduce the likelihood of missing a treatable cause of hypertension.