nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2023-27-1-31-40nefr-2194Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESДиагностика, мониторинг и лечение артериальной гипертензии у детейDiagnostics, monitoring and treatment of arterial hypertension in childrenhttps://orcid.org/0000-0002-9356-4870КаримджановИ. А.KarimdzhanovI. A.

Ильхамджан Асамович Каримджанов, проф., д-р мед. наук

кафедра детских болезней № 2

100102

ул. Фароби, д. 2

Ташкент

тел.: (+998) 903515346

Ilhamdzhan A. Karimdzhanov, Prof., MD, PhD, DMedSci

Department of Children's Diseases № 2

100102

Farobi St., 2

Tashkent

Tel. (+998) 903515346

dr.ilhomjon@mail.ruhttps://orcid.org/0000-0003-3577-499XИскановаГ. Х.IskanovaG. Kh.

Гулшан Холдоровна Исканова, доц., канд. мед. наук

кафедра детских болезней № 2

100102

ул. Фароби, д. 2

Ташкент

тел.: (+998) 903706440

Gulshan Kh. Iskanova, Associate professor, MD, PhD

Department of Children's Diseases № 2

100102

Farobi st., 2

Tashkent

Tel. (+998) 903706440

gulshan1972iskanova@gmail.comhttps://orcid.org/0000-0002-1234-9475ИсраиловаН. А.IsrаilovaN. A.

Нигора Амануллаевна Исраилова, асс., канд. мед. наук

кафедра детских болезней № 2

100102

ул. Фароби, д. 2

Ташкент

тел.: (+998) 90 1757180

Nigora A. Isrаilova, Assistant, MD, PhD

Department of Children's Diseases № 2

100102

Farobi st., 2

Tashkent

Tel. (+998) 90 1757180

nigora99@gmail.comТашкентская медицинская академияУзбекистанTashkent Medical AcademyUzbekistan2023060320232713140Copyright © Каримджанов И.А., Исканова Г.Х., Исраилова Н.А., 20232023Каримджанов И.А., Исканова Г.Х., Исраилова Н.А.Karimdzhanov I.A., Iskanova G.K., Isrаilova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2194

   В обзоре приведены материалы об актуальности АГ у детей в настоящее время. Распространенность АГ у детей в возрасте 6–18 лет с избыточной массой тела и ожирением составляет 27–47 %, в то же время вторичная артериальная гипертензия остается доминирующей, особенно у детей младше 5 лет. АГ является основным фактором риска атеросклероза и сердечно-сосудистых заболеваний у взрослых. Начало этих заболеваний может происходить в детском или юношеском возрасте. Использование современных методов для мониторинга и контроля АД имеет решающее значение для улучшения управления АГ и предотвращения повреждения органов-мишеней. Круглосуточные измерения АД являются важным инструментом в определении прогноза и лечения детей с АГ. АГ у детей может быть классифицирована как первичная или эссенциальная, если нет идентифицируемой причины, или как вторичная АГ, когда она возникает из-за конкретной причины. Частота первичной артериальной гипертензии увеличивается с возрастом, в то время как вторичная артериальная гипертензия преобладает в раннем и детском возрасте. Вторичные причины АГ также зависят от возраста пациента. Так у 34–79 % больных с вторичными формами артериальной гипертензии выявляются паренхиматозные заболевания почек и нарушение их структуры. Выявляются такие признаки АГ, как головная боль, визуальные нарушения, головокружения и носовые кровотечения. Одышка при физической нагрузке, параличлица и судороги указывают на поражение органов-мишеней. У детей с ожирением, диабетом, почечной недостаточностью, коарктацией аорты / восстановленной коарктацией и получающих лекарства, вызывающие АГ, следует измерять АД при каждом визите к врачу. Терапевтические изменения образа жизни являются ранним методом терапии при лечении АГ у детей. ИАПФ, БКК, БРА и тиазидные диуретики являются наиболее эффективными препаратами при АГ у детей.

   The review presents material on the current relevance of AH in children. The prevalence of AH in overweight and obese children aged 6-18 years is 27–47 %, while secondary arterial hypertension remains dominant, especially in children younger than 5 years. AH is a major risk factor for atherosclerosis and cardiovascular disease in adults. The onset of these diseases may occur in childhood or adolescence. The use of modern methods to monitor and control BP is crucial for improving the management of AH and preventing damage to target organs. Twenty-four-hour BP measurements are an important tool in determining the prognosis and treatment of children with AH. AH in children can be classified as primary or essential if there is no identifiable cause, or as secondary AH when it arises from a specific cause. The incidence of primary arterial hypertension increases with age, whereas secondary arterial hypertension predominates in early childhood. The secondary causes of AH also depend on the age of the patient. Thus 34-79 % of patients with secondary forms of arterial hypertension have renal parenchymal disease and impaired renal structure. Signs of AH include headache, visual disturbances, dizziness and nosebleeds. Dyspnoea on exercise, facial paralysis and seizures indicate target organ damage. In children with obesity, diabetes, renal insufficiency, aortic coarctation/repaired coarctation and those receiving medication causing AH, BP should be measured at every visit to the physician. Therapeutic lifestyle changes are an early therapy in the treatment of AH in children. IAPs, BCAAs, BRAs and thiazide diuretics are the most effective drugs for AH in children.

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The authors declare that there are no conflicts of interest present.