For a longtime interest on hypertension in children and adolescents has been largely limited to the problems posed by the diagnostic identification of secondary causes of the blood elevation. This has changed in the last two decades, however, which have been characterized by 1) a marked increase in the studies on blood pressure elevation in the young age and 2) the evidence that, like in the primary or essential hypertension of adults, this elevation can occur with no evidence of any secondary nature. It has also been clarified that several abnormalities associated with primary adult hypertension (e.g. asymptomatic alterations in organ structure and function) recognize their root in the young age, sometimes even at birth or soon after birth. This finding has not only further highlighted the importance to devote a greater attention to BP abnormalities in children but it has also generated the possibility that preventing these abnormalities may make protection against hypertension in adults more complete. Namely that it may effectively address one of the most serious problems of adult hypertension, i.e. that even an effective blood pressure lowering treatment cannot bring back the cardiovascular risk to the level of normotensive controls.
Nevertheless, current attention to pediatric hypertension is far from what this relatively novel medical area deserves, given its paramount importance for public health and its many unresolved diagnostic, prognostic and therapeutic issues. For example, the best way to measure blood pressure and the proper cut-off values dividing hypertension from normotension in children are still debated. It is still unclear which factors favour or prevent an increased blood pressure in children to progress to adult hypertension. The difficult decision to complement lifestyle measure with antihypertensive drugs is still largely left to the physician judgment in many young hypertensive patients.
A potential instrument to help facing the above challenges in HyperChildNET, a European Network for blood pressure research and education in children and adolescents provided by the COST programme and the Horizon 2020 of the European Community. The main objectives of HyperChildNET are 1) to establish a sustainable network extended to the European continent and characterized by multidisciplinary competences; 2) to acquire a better understanding of the factors that precede and coexist with high BP in children and adolescents, clarifying their associated or causative nature; 3) to improve, via collection of European-based data and reference office and out-of-office BP values, the diagnosis of hypertension and its associated risk factors and organ abnormalities in the pediatric population and 4) to increase the awareness of the importance and the quality of the collected information on pediatric hypertension across the continent.
The above are ambitious goals which will be addressed by HyperChildNET via a network that includes 23 countries and that for the first time extends to all multidisciplinary aspects that are involved in blood pressure elevation phenotypes of the young age: researchers, health professionals, industry professionals, decision makers and stakeholders. This extensive interactive network holds great promise to successfully address several problematic aspects of this area. Above all, to give it a wide visibility for the first time, leading to a generalized perception of its importance and leading, just to mention the implementation of a simple but key procedure, to the regular measurement of blood pressure from the early age onward. And to also advance scientific knowledge in this area. To this aim, the activity of HyperChildNET will include promotion of talented investigators in the early phase of their carrier and sponsorship of scientific news, communication and research.
Professor Giuseppe Mancia
Emeritus Professor of Medicine, University Milano-Bicocca
President ESH Foundation/Chairman ESH Educational Board
- International Soc Hypertension
- European Soc Hypertension
- European Soc Clin Investigation
- Italian Soc Hypertension
- WG Hypertension and the Heart, Eur Soc Cardiol
Highly cited researcher, Clinical Medicine (Clarivate)
Chairman,Consulta of the Italian Scientific Societies for Cardiovascular Prevention
Former Head, Dpt of Medicine, S.Gerardo Hospital,Monza, Italy
Leader of Working Group on Reference Values Cost Action HyperChildNET