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Hypertension in Pediatrics

Hello, My article is on lifestyles and its contribution to hypertension in pediatrics. Hypertension in children and adolescents is a growing health concern that should be taken seriously and diagnosed early. A CDC study shows that about 1 in 25 youth ages 12 to 19 have hypertension, and 1 in 10 has elevated blood pressure (CDC,2017).Hypertension is one of the world's most common diseases with a high death rate . Hypertension is not only as a common disease, but also known as one of the most prevalent human diseases, leading to high morbidity and mortality , (Bromfield S, Muntner P.,2013). The prevalence of essential hypertension in adolescents is different among diverse ethnicities from as low as 0.3% up to approximately 21% ,(Wuhl E.,2019).A study on about 25,000 schoolchildren revealed a higher prevalence of hypertension in overweight and obese children in comparison to normal weight participants (17%-18% vs. 10%) (Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK.,2007).It was thought for many years that it was a problem that only affected adults. Due to modern day lifestyles the incidence of hypertension has increased in children over time. In the past, hypertension and its harmful consequences were attributed to adult patients, and it was unusual in childhood and secondary to some disorders of the renal, endocrine, and cardiac, (Sharma S, Meyers KE, Vidi SR.; Flynn J, Ingelfinger JR, Redwine K. ,2016).Secondary causes that contribute to hypertension are seen more in children. In looking at policies there is no consensus on the best initial antihypertensive medication to use in children, and there have been no clinical trials of hypertension treatment in children that measured patient-oriented, long-term outcomes. Dietary patterns, physical activity, and stress have main roles in the incidence and prevention of hypertension in children and adolescents. ( Giontella A, Bonafini S, Tagetti A, Bresadola I, Minuz P, Gaudino R, et al.,2019). Children with symptomatic hypertension (e.g., headaches, cognitive changes), stage 2 hypertension without a modifiable factor such as obesity, evidence of left ventricular hypertrophy on echocardiography, any stage of hypertension associated with chronic kidney disease or diabetes, or persistent hypertension despite a trial of lifestyle modifications require antihypertensive medications (Flynn JT, Kaelber DC, Baker-Smith CM, et al.,2017). Weight loss should be encouraged for children who are overweight or obese, and those who are obese should be referred for comprehensive, intensive, family-oriented behavioral intervention programs, (Flynn JT, Kaelber DC, Baker-Smith CM, et al.,2017). The World Health organization has made several recommendations to a healthy life style in children .Since the World Health Organization recommended to engage in moderate-to-vigorous physical activity for at least 1 h a day in childhood ,(World Health Organization, 2015). There is no evidence-based guideline to recommend a specific length for a lifestyle modification trial, but various research studies suggest a period of three to six months is sufficient to determine likely effectiveness (Flynn JT, Kaelber DC, Baker-Smith CM, et al.,2017). It is suggested that children with preexisting conditions have blood pressure taken yearly beginning at age 3, (