American Academy of Family Physicians

One of the deadliest and common communicable diseases today is hypertension. This disease is not only common in adults, but in children as well. According to the American Academy of Family Physicians (2006), certain factors are necessary in the possible detection and intervention of childhood hypertension. These include the epidemic of childhood obesity, the risk of developing left ventricular hypertrophy, and evidences of early development atherosclerosis in children. However, supporting data for children under the age of twelve is not available.

Most childhood hypertension, particularly in preadolescences, aged eleven to fourteen, is secondary to an underlying disorder. One of these is renal parenchymal disease. This disease is known as the most common cause of hypertension in adolescents, targeting sixty to seventy percent of the population. In addition to this, adolescents usually have primary hypertension, comprising eighty five to ninety five percent of all cases. Hypertension is defined as having the systolic blood pressure above 140 mmHg of accuracy, or a diastolic pressure of above 90 mm of mercury, based on two or more measurements.

In addition to this, blood pressure is the amount of blood produced by the blood in relation to the blood flow resistance in the arteries. Blood pressure increases as the blood pumped by the heart increases. This also causes the constriction of the arteries of the heart, causing hypertension (Mayo Clinic Staff, June 5, 2007). There are two types of hypertension, namely Essential and Secondary Hypertension. For adults with hypertension, there is an estimated ninety to ninety five percent of people who actually have essential hypertension.

This type has no distinctive cause, but may appear analyzable and inheritable. High blood pressure may occur when there is an increase in the peripheral resistance. In addition to this, Increased sympathetic stimulation must result to cardiac output, the sodium renal reabsorption is increased, and there is insulin action resistance (Guyton & Hall, n. d. ). Hypertension may also be classified as Optimal, Normal, High Normal, Stage 1, Stage 2, and Stage 3. Optimal hypertension has a diastolic of 80 mmHg and a systolic of 120 mmHg; Normal on the other hand, has a systolic of 130 mmHg and a diastolic of 85 mmHg.

Furthermore, High Normal hypertension has a systolic ranging from 130 mmHg to 139 mmHg, and a diastolic ranging from 85 mmHg to 89 mmHg, while Stage 1 has a systolic range of 140 mmHg to 159 mmHg, and a diastolic range of 90 mmHg to 99 mmHg. Moreover, Stage 2 has a systolic range of 160 mmHg to 179mmHg, and a diastolic range of 100 mmHg to 109 mmHg, while Stage 3 has a systolic of 180 mmHg or higher, with a diastolic of 110 mmHg or higher (Brunner & suddarth, 2004, vol 2, p. 652).

When sudden hypertension occurs, this leads to a fast paced reaction of the body, leading to the emergency state of hypertensive crisis (Guyton & Hall, n. d. ). Hypertensive crisis occurs when the blood pressure must immediately be lowered and monitored to 140/90 mmHg. This procedure inhibits possible organ damage. This means that the lowering of the pressure must be done in a few hours after its increase. The serious organ damage that may occur facilitates treatment in an intensive care setting, where everything is monitored (Smeltzer, 2004).

Hypertension, in general, affects more women of all races, than men. But studies have shown that African-American men are more prone to acquiring such disease. The reasons, until now, are identifiable (Armenian Medical Network, 2006). Certain factors characterize secondary hypertension. These include blood pressure elevation, diseases such as arterial and renal, medications, and even pregnancy. Moreover, hypertension may also be classified as a sign of another condition; serving as explanation for the sudden change in cardiac output.

Symptoms of secondary hypertension include high blood pressure, retina changes with hemorrhages, narrowed arterioles, and papilledema. These symptoms normally signal damages occurred in the organ systems and in the vessels, such as angina caused by Coronary artery disease, or even the fatal myocardial infarction. Others include the pathological changes in the kidney, and cerebrovascular involvement, known as the stroke or transient ischemic attack (Smeltzer, C, 2004). Assessment and diagnosis of a hypertensive person is possible through methods.

These include the medical history, physical examination, laboratory studies for organ damage, urinalysis, blood chemistry, electrocardiogram (ECG), and echodiagram. According to Johnson and Joyce Young (2004), the goal of any treatment program is to prevent death and complications by achieving and maintaining an arterial blood pressure below 140/90 mmHg whenever possible. Hypertension, if not treated, may include potential complications, such as heart and kidney failure, transient ischemic attack, myocardial infarction or ventricular hypertrophy (Johnson, Joyce Young, 2004, p. 433).

Some non-pharmacologic approaches to the treatment of such disease are weight reduction; alcohol, sodium and tobacco resistance, regular exercise, and consistent relaxation. A dietary approach to stop Hypertension (DASH) program includes a diet high in vegetables and low intake of dairy products. This program has been shown to lower the elevated blood pressure. Dextrose-recommended treatment had the greatest effectivity, with the least contraindications, and the best chance of acceptance from the patient. Two classes of drugs are available as its first-line treatment therapy: Diuretics and Beta-Blockers.

These may include Hydrochlorothiazide, Furosemid (Lasix), and Spironolactone (Adalactone). These drugs may be beneficial in the upheaval of the health of hypertensive individuals. The best treatment that can be given to a hypertensive individual is to be extra precautious with their diet and lifestyle. Besides, prevention is better than any other treatment.


American Academy of Family Physicians. (2006). Hypertension in Children and Adolescents. Retrieved on July 24, 2007 from http://www. aafp. org/afp/2060501/1558. html Armenian Medical Network. (2006).

Hypertension Etiology & Classification-Secondary Hypertension. Retrieved on December 2, 2007 from http://www. health. am/hypertension/secondary-hypertension/ Guyton, A. C. , & Hall, J. E. (n. d. ). Textbook of medical physiology 7th edition. Elsevier- Saunders, p220. Mayo Clinic. (2007, June 5). High Blood Pressure. Retrieved March 27, 2008 from http://www. mayoclinic. com/health/high-blood-pressure/DS00100/DSECTION=1 Smeltzer, Susan C. (2004). Brunner and suddarth’s textbook of medical-surgical nursing 10th edition. Lippincott Williams & Wilkins.

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