Childhood obesity is associated with a significant increased risk for several metabolic and cardiovascular complications, including hypertension. The main mechanisms implicated in the pathogenesis of high blood pressure in relation to increased body weight are insulin resistance/hyperinsulinemia, sympathetic nervous system hyperactivity and alterations in vascular structure and function. Obesity-related hypertension is associated with cardiovascular complications already during childhood and with an increased risk of coronary heart disease in adulthood. A high prevalence of the nondipping phenomenon has also been detected in obese children and adolescents and this is worrying as this condition is associated with end-organ damage. Assessing blood pressure is therefore particularly important in obese children and adolescents for an early detection of its alterations. Ambulatory blood pressure monitoring represents an important method of measuring blood pressure, particularly in the suspicion of white-coat hypertension, masked hypertension and non-dipping phenomenon. Prevention and treatment of childhood obesity represent important means in order to prevent and reduce the incidence of hypertension and the associated cardiovascular risk. Reduction in body weight is generally the first step in the management of obesity-related hypertension. However, in severe cases or in cases non responsive to lifestyle interventions, drug therapy should be considered.
Keywords: Hypertension, blood pressure, obesity, children, cardiovascular disease, complications
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