Childhood hypertension: A call to action for early diagnosis and management

World Hypertension Day is celebrated on May 17 every year. At the Sindh Institute of Urology and Transplantation (SIUT), in 2024, a seminar was organized by the Department of Paediatric Nephrology about “Childhood Hypertension: Call to Action for Early Diagnosis and Management.”

This seminar was fully endorsed by the International Paediatric Nephrology Association (IPNA), Asian Society of Pediatric Nephrology (ASPNA), Pakistan Society of Nephrology (PSN), Pakistan Paediatric Association Nephrology Group (PPA- Nephrology) and the Accreditation Council for Continuous Medical Education.

It was a whole day activity in which about 100 in-person registrants and there about 400 online registrants from 30 countries. The target audience was all the healthcare workers who are involved in the care of children who are diagnosed with hypertension. Among the participants, there were nephrology trainees and consultants of both adult and paediatric specialties as well as a large number of paediatric consultants and trainees.

Hypertension is known to be a “silent killer”. It slowly damages almost all the vital organs including the heart, kidneys, eyes, and the brain. Its manifestations are usually seen in adults when they present with end-organ damage. In children, hypertension is not as common as in adults; however, a globally increasing number of children are being diagnosed with hypertension.

In the past, most of the children with hypertension had an underlying condition like kidney failure, tumor, or a birth defect leading to high blood pressure. Nowadays, with the increasing prevalence of obesity, sedentary lifestyle, and drug abuse in teenagers, the prevalence of primary hypertension in children is also increasing.

This seminar was moderated by the Department of Paediatric Nephrology at the SIUT. There were national and international speakers who discussed at length the diagnosis and management of all the varieties of childhood hypertension.

The International speakers included Dr Rupesh Raina and Irfan Agha from the USA, Dr Swasti Chaturvedi from Australia, and Dr Zainab Arslan from London, while national speakers included Dr Amir Hameed from Ziauddin University, Salman Kirmani from the AKUH and Dr Shazia Mohsin from the SIUT. All the speakers shared their expertise on specific topics, which was followed by an academic discussion with special emphasis on the approach towards children residing in countries with limited resources.

The need for screening all healthy children after three years of age by checking the blood pressure at least once and screening and monitoring children with risk factors like obesity, premature birth, kidney disease, heart disease, and other chronic conditions was endorsed and emphasized during the seminar. Early referral to specialists with expertise in specific areas is also known to prevent future complications. Specific diagnostic tools were also discussed.

All the speakers and participants thanked SIUT and the Department of Paediatric Nephrology for organizing the event. Academic collaboration by sharing knowledge and expertise between institutions and encouraging the upcoming doctors to obtain structured training in sub-specialties was also emphasized.