Primary hypertension and metabolic syndrome in childhood: a case report

Ozet Cocukluk ca¤›nda hipertansiyon, etiyolojisi ve tedavisi eriflkinlerden farkl› olan onemli bir klinik sorundur. Gunumuzde cocuk ve adole- sanlarda da esansiyel hipertansiyon tan›mlanmaktad›r. Esansiyel hi- pertansiyonu olan cocuk ve adolesanlar s›kl›kla fazla kiloludur. Tan- siyon arteriyeli 95. persentil uzerinde olan kilolu-obez cocuklarda di- ¤er kardiyovaskuler risk faktorleri, lipid paneli ve glukoz duzeyi de- ¤erlendirilmelidir. Hipertansiyon, santral obezite-artm›fl vucut kitle indeksi, dislipidemi, insulin direnci-diyabetes mellitus ile tan›mlanan metabolik sendrom; cocukluk doneminde artm›fl kardiyovaskuler risk ve diyabet nedenidir. Burada, esansiyel hipertansiyon ve meta- bolik sendromu tan›s› alan 7 yafl›nda k›z cocuu sunulmaktad›r. Esansiyel hipertansiyon ve metabolik sendromu olan cocuklar›n te- davisi; hasta ve aile eitimi, nonfarmakolojik onlemler ve farmako- lojik tedavileri iceren ayr›nt›l› bir yaklafl›m gerektirir. Hipertansiyon tan›s› icin cocuklarda uc yafl›ndan itibaren tansiyon olcumunun her fizik muayenede yap›lmas› gerektii unutmamal›d›r. Summary Childhood hypertension which differs from adults with its definition, etiology and management, is an important clinical problem. Primary (essential) hypertension is now identifiable in children and adolescents. Children and adolescents with primary hypertension are frequently overweight. Children who are overweight-obese and with arterial pressure greater than the 95th percentile need to be evaluated for other cardiovascular risk factors, lipid panel and glucose levels. Metabolic syndrome, defined as hypertension, central obesity- increased body mass index, dyslipidemia, insulin resistance-diabetes mellitus, is a cause of increased cardiovascular risk and diabetes. Here, a 7-year-old female patient with primary hypertension and metabolic syndrome is presented. Management of hypertension and metabolic syndrome in children require a comprehensive approach incorporating patient and family education, non-pharmacological measures and pharmacological treatments. For the diagnosis of hypertension, in every physical examination, arterial pressure measurement of children from the age of three should not be forgotten.