Hypertension in Pediatric Solid Organ Transplant Recipients.

IF 3.9 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2023-05-01 DOI:10.1007/s11906-023-01237-5

Gilad Hamdani, Mark M Mitsnefes

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引用次数: 0

Abstract

Purpose of review: To review the current literature regarding hypertension (HTN) following pediatric solid organ transplant (SOTx), including definition, prevalence, risk factors, outcomes, and treatment.

Recent findings: In recent years several new guidelines for the definition, monitoring, and management of pediatric HTN have been published, but with no specific recommendations regarding SOTx recipients. HTN remains highly prevalent, yet underdiagnosed and undertreated in kidney transplant (KTx) recipients, especially when ambulatory blood pressure monitoring (ABPM) is utilized. There are little data regarding its prevalence in other SOTx recipients. HTN in this population is multifactorial and is associated with HTN status prior to Tx, demographic factors (age, sex, and race), weight status, and immunosuppression protocol. HTN is associated with subclinical cardiovascular (CV) end-organ damage, including left ventricular hypertrophy (LVH) and arterial stiffness, yet there are no recent data regarding its long-term outcomes. There are also no updated recommendations regarding the optimal management of HTN in this population. Given its high prevalence and the young age of this population facing years at increased CV risk, post-Tx HTN requires more clinical attention (routine monitoring, frequent application of ABPM, better BP control). Additional research is needed for a better understanding of its long-term outcomes as well as its treatment and treatment goals. Much more research is needed regarding HTN in other pediatric SOTx populations.

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儿童实体器官移植受者的高血压。

综述目的:回顾目前关于儿童实体器官移植(SOTx)后高血压(HTN)的文献，包括定义、患病率、危险因素、结局和治疗。最近的研究发现:近年来，一些关于儿科HTN的定义、监测和管理的新指南已经发表，但没有针对SOTx接受者的具体建议。HTN在肾移植(KTx)受者中仍然非常普遍，但诊断和治疗不足，特别是在使用动态血压监测(ABPM)时。关于其在其他SOTx接受者中的流行程度的数据很少。该人群中的HTN是多因素的，与Tx前的HTN状况、人口统计学因素(年龄、性别和种族)、体重状况和免疫抑制方案有关。HTN与亚临床心血管(CV)终末器官损伤相关，包括左心室肥厚(LVH)和动脉僵硬，但目前尚无关于其长期预后的最新数据。关于这一人群HTN的最佳管理也没有最新的建议。考虑到HTN的高患病率和该人群的年轻年龄面临CV风险增加的年龄，tx后HTN需要更多的临床关注(常规监测，频繁应用ABPM，更好的血压控制)。需要进一步的研究来更好地了解其长期结果以及治疗和治疗目标。需要对其他小儿SOTx人群的HTN进行更多的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.