Can teenagers get high blood pressure? The meaning of three highs

Hypertension is usually considered as an adult disease. In fact, hypertension in children is not uncommon. It is reported that the incidence of hypertension among children in the United States and Japan is 14. 1% and 13.3% respectively. When Beijing Children's Hospital conducted a blood pressure survey on 5000 children and adolescents aged 6 ~ 18, it was found that 9.36% of children and adolescents suffered from hypertension. 65438-0979 Guangdong Institute of Cardiovascular Diseases conducted a general survey of 3826 rural children aged 4- 16. According to the standard adopted in China, the prevalence rate of hypertension is 0.86%. This figure shows that there are tens of thousands of children with hypertension in China.

Hypertension in children can be divided into primary hypertension and secondary hypertension. The pathogenesis of essential hypertension is complex, and the increase of blood pressure is related to many factors. At present, most scholars believe that it is mainly caused by the following factors.

(1) Neuroendocrine factors Children's brains and central nervous system are in an underdeveloped period, and they are easily excited and tired. For children with fragile nerves, if they are stimulated by family, school and social environment factors, such as family discord, divorce of parents, frequent scolding and overwork, etc. The excitement and inhibition of cerebral cortex will be unbalanced, and they can easily form vasomotor centers under the cortex, which are dominated by vasomotor impulses.

Bad stimulation can also cause autonomic nervous system disorder, regulatory failure, and cause changes in endocrine hormones in body fluids. Sympathetic nerve excitation causes adrenal medulla to secrete too much adrenaline and norepinephrine, which causes blood pressure to rise. Long-term vasospasm and poor blood circulation of arterioles lead to organ ischemia, especially in renal ischemia. Cells around glomerulus secrete more renin, which acts on angiotensinogen after entering systemic circulation, forming angiotensin ⅰ and ⅱ, further aggravating systemic arteriospasm. At the same time, it will also promote aldosterone secretion, sodium and water retention, increase blood volume, thus making blood pressure stubbornly rise.

(2) Genetic factors are also important factors in the pathogenesis of hypertension in children. According to reports, parents have high blood pressure, and the probability of their children having high blood pressure is twice as high as that of their parents without high blood pressure. One parent has hypertension, and 65,438+0/3 children may have hypertension. According to other data, both atherosclerosis and hypertension originated in childhood. Children with hypertension under 15 years old were followed up, the youngest of whom was only 3 years old. Some scholars also pointed out that hypertension is a kind of cell membrane disease, the function of cell membrane is abnormal, the treatment system of membrane calcium pump is out of order, and some children have developed the habit of taking too much salt as flavoring agent. This high sodium and low potassium environment is another basic factor leading to hypertension in children.

(3) Obesity caused by high-sugar and high-fat diet and overnutrition. A person's blood pressure will increase with the increase of weight. For every 20 pounds of weight gain, diastolic blood pressure increases by 0.53 kPa. The incidence of hypertension in obese children is 2 ~ 6 times higher than that in normal weight children. Therefore, childhood obesity is also a risk factor for hypertension.

Secondary hypertension is also very common in children, with various causes, such as acute and chronic glomerulonephritis, renal artery stenosis, congenital urinary malformation, congenital aortic valve stenosis, adrenal cortical hyperplasia, adrenal tumor and so on. In a word, diseases of urinary system, cardiovascular system, endocrine system and nervous system can all cause hypertension.

Hypertension in children and young people is not exactly the same as that in adults. It has the following characteristics:

(1) The symptoms of hypertension in children and young people are atypical. It is often found that their clinical manifestations are different from those of adults in physical examination. Some people may have no symptoms, others may have headaches, but the specificity is not strong, and they may even be mistaken for other system diseases. Some symptoms of hypertension in children and adolescents should attract the attention of clinicians and parents, such as growth retardation, nausea, vomiting, irritability, inactivity, visual impairment, and even facial paralysis, stroke, cardiac insufficiency and so on. , and should go to the hospital for further diagnosis and treatment in time.

(2) There is often a family history of hypertension. It is reported that more than 50% of children and adolescents have a family history of essential hypertension. As long as one parent suffers from primary hypertension, the chances of their children suffering from hypertension are greater. In addition, 50% of children and adolescents suffer from hypertension with obesity, so we should pay attention to these pathogenic factors when preventing hypertension in children and adolescents.

(3) Hypertension is mostly secondary hypertension in children and young people. If the blood pressure is high, 80% is secondary hypertension. Therefore, it is particularly important for children and adolescents to actively seek the cause of hypertension. The common causes of secondary hypertension are as follows: ① Cardiovascular aspects: congenital aortic stenosis, abdominal aortic dysplasia, aortic insufficiency, patent ductus arteriosus, etc. ② Kidney: acute glomerulonephritis, chronic nephritis, chronic pyelonephritis, acute renal failure, etc. ③ Renal vessels: Takayasu arteritis involves renal vessels, poor fibrous structure of renal artery, trauma, etc. ④ Endocrine aspects: pheochromocytoma, primary aldosteronism, etc.

Generally speaking, secondary hypertension is not difficult to diagnose according to typical symptoms and related special examinations. Once diagnosed, we should actively treat and remove the cause, and some secondary hypertension can be cured after removing the cause.

(4) Children and young people have fewer complications of hypertension. Because children and young people have strong tolerance to hypertension, there are generally no complications such as stroke, myocardial infarction and renal insufficiency. If urine poisoning occurs, it may be mainly caused by kidney disease itself. In terms of treatment, unless there is obvious symptomatic hypertension, it is generally not appropriate to quickly reduce blood pressure. It usually takes weeks to months to get down to a safe level. The goal of treatment is not only to let children and young people continue to participate in various activities, but also to prevent target organ damage caused by hypertension. In addition to drug therapy, non-drug therapy is more important. It is suggested to strengthen physical activity, maintain ideal weight, limit salt intake and prohibit smoking. Three highs refer to hypertension, hyperlipidemia and hyperglycemia.