- For hypertension, in the transition from childhood to adulthood, a patient will have the same treatment target and hypertension stage and similar medication choices.
- Long-term risk stratification to age 40 years for pediatric patients remains a gap.
Why this matters
- These authors say that the guidelines should remain separate for the populations while emphasizing awareness of the transition stage.
- The guidelines are similar in the kind of information they provide, including BP measurement technique and health disparities.
- In both cases, multiple measurements are recommended, emphasizing ambulatory or home monitoring.
- Both guidelines emphasize lifestyle management for stage I hypertension.
- They differ in special populations they emphasize because of intrinsic differences for some conditions by age.
- Recommendations for diagnostic evaluation are similar, with lipid profile, blood chemistry, urinalysis, and evaluating for secondary hypertension.
- Specific to pediatric is renal ultrasound in young patients, HbA1c and liver function evaluation, and suspicion for secondary causes in children without overweight/obesity.
- Specific to adult guidelines are complete blood count, thyroid evaluation, and ECG.
- After age 13 years, categories of diagnosis are the same.
- Pediatric-adult care transition remains unsatisfactory for treatment adherence.
- Trials in children and young adults ages 20-40 years are lacking, leaving gaps.