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After several months of inactivity due to reasons beyond my control I am back again trying to do my hardest in the fight against arterial hypertension (HTN).
During this time I got the fortune of being designated as a Fellow of the American Colleague of Cardiology which fills me with pride and creates at the same time a new commitment in my medical practice (see video) striving to keep cardiovascular disease away and if this is true for adults, when is comes to adolescence or childhood is imperative.
Taking into account the above mentioned, I would like to make a point regarding the latest Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents just published at the end of last year 2017. Just three things I want to stress:
The authors of the Guideline continue to emphasize the importance of life style modifications in children and adolescents, which is something that at times is unfulfilled with many factors on the table taking turns. This will be a subject will go into later on a new post.
The matter of the early cardiac impairment related with hypertension from childhood is another important issue to look at.
Last but not least, a smart prevention by using a proper prediction since early in life is key.
These topics will be covered further in-depth.
I also want to add that the first HAMAD Corporation-approved investigation from the Cuban Hospital just kicked off this month and will enroll adolescent from all over Qatar (national reach) in order to go deeper over the matter.
Please keep awaiting more posts with new updates and details.
(Lead Investigator of the investigation related with HTN and adolescence approved by HAMAD Corporation)
1- New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents. Flynn JT, Falkner BE. New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents. Hypertension. 2017 Oct;70(4):683-686.
This post has been written by Dr. Guillermo Alberto Perez Fernandez and represents his personal opinion on the topic.
September is already going on. In most countries, this month denotes the start of the academy year in the school system, thereby, I felt that this post would fit in well.
It has been addressed before on this blog the repercussions of arterial hypertension since early in life. However, there is an effect that most times is missed: the impact on the school performance in our children and adolescence.
Unlike some people might think, there is a connection.
Although it is well-known the influence of hypertension on several organs of the human body as kidney, heart and brain among others in adults. The impact on the brain since childhood has been barely described and most reports in the past were limited to gross neurologic events, such as facial palsy, seizure and stroke in children with malignant hypertension.
Nowadays, the medical community is focusing on the association of arterial hypertension and neurocognition since early in life.
Neurocognition: Any form of cognition (the mental process of thinking and understanding) that is associated with the functioning of one or more specific areas of the brain.
What has the medical community found out on this so far?
Children with newly diagnosed or untreated primary hypertension have decreased performance on neurocognitive measures of attention, learning, memory, and fine motor ability compared with those being normotensive regardless maternal education, race, ethnicity, age and sex.
Hypertension in early in life often clusters with other cardiovascular risk factors with further negative effects on cognition, including obstructive sleep apnea, metabolic syndrome, insulin resistance and hyperlipidemia (1,2)
Therefore, the impact of hypertension early in life on neurocognition is clear.
In addition, to make things more complicated, often the school environment may be stressful and challenging for some children which adds up stress to the equation; another variable proven to be strongly related with high blood pressure as I already published some time ago (3)
Then, my recommendation is this: check on any children or adolescent with a poor school performance. Hypertension might be backstage.
1- Lande, M.B., Kupferman, J.C., and Adams, H.R. Neurocognitive alterations in hypertensive children and adolescents. J Clin Hypertens (Greenwich). 2012; 14: 353–359.
2- Hooper SR. Risk Factors for Neurocognitive Functioning in Children with Autosomal Recessive Polycystic Kidney Disease. Front Pediatr. 2017 May 15;5:107.
3- Perez Fernández GA. Hipertensión arterial, estrés y rendimiento académico para la evaluación integral del adolescente hipertenso o en riesgo. Medicentro. 2011; 15(3). (Available at : http://www.medicentro.sld.cu/index.php/medicentro/article/view/238)
Whenever someone have asked me- What makes so difficult to approach and control arterial hypertension and its related health conditions?
My response is loud and clear: The complexity of the tangled skein we must deal with as health care providers.
The problem is that there is a growing number of risk factors with a very complex interrelation.
Nowadays, another has been summed up to the list: the screen time or in other words, the time spent on social media, video games, watching television, music videos, advertising, etc.
It is not a secret that is increasingly rare to see kids and adolescents playing games outdoor unless these are part of the school program they belong to. Children are no longer playing hide-and-seek outside or reading a good hard-cover book. Instead, they’ve dived into a world of constant digital media through television, mobile devices and video games.
According to the latest statistics about the topic: Continue reading “Long screen time and cardiovascular disease in children and adolescents. Social media and video games might be taking their toll.”