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Bluthochdruck bei Adipositas im Kindes- und Jugendalter

High blood pressure in obese children and adolescents

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Adipositas ist auch bei Kindern und Jugendlichen ein bedeutsamer Risikofaktor für eine „essentielle“ Hypertonie, und anders als früher angenommen, hinterlässt der hohe Blutdruck auch schon bei ihnen messbare Schäden am Herz-Kreislauf-System. Wie bei Erwachsenen führt der erhöhte Blutdruck zur Herzvergrößerung, Verkalkung der Herzkranzgefäße und Verdickung der Wände kleiner Gefäße. Die Schädigung ist vor allem dann zu beobachten, wenn Adipositas und andere Risikofaktoren wie erhöhte Blutfette, Hyperinsulinämie und Rauchen hinzukommen. Wie bei jedem Kind mit erhöhtem Blutdruck, muss die Diagnostik die chronische Hypertonie bestätigen, die Ursache der zugrunde liegenden Ursache klären und untersuchen, ob Zielorgane geschädigt sind. Neue Referenzwerte für die Gelegenheitsblutdruckmessung wurden kürzlich in einer repräsentativen Bevölkerungsstudie in Deutschland erhoben. Die Behandlung sollte mit Veränderungen des Lebensstils beginnen, aber oft wird auch eine Behandlung mit Antihypertensiva nötig. Bluthochdruck ist bei Jugendlichen mit Adipositas nicht selten und muss adäquat diagnostiziert und behandelt werden.

Abstract

Obesity is also an important risk factor in children and adolescents for “essential” arterial hypertension, and contrary to what was assumed earlier, high blood pressure does cause damage to the cardiovascular system. As known from adults, elevated blood pressure induces cardiac hypertrophy, calcifications and atherosclerosis at the coronary vessels and thickens the small blood vessels. These early vascular alterations are particularly pronounced, when increased blood pressure is accompanied by other risk factors, such as dyslipidemia, hyperinsulinemia or smoking. As in any child with elevated blood pressure, the diagnostic evaluation should focus on confirmation of hypertension, determine if an underlying cause can be identified and whether hypertensive target organ damage is present. New reference office blood pressure values were recently published by a large representative community-based study in Germany. Therapy should begin with lifestyle modifications; however, antihypertensive medications will often be needed. Hypertension in obese adolescents occurs frequently and must be diagnosed and treated adequately.

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  1. Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Loschgestr. 15, 91054, Erlangen, Deutschland

    W. Rascher

  2. Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig, Deutschland

    W. Kiess & A. Körner

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  1. W. Rascher
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  2. W. Kiess
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  3. A. Körner
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Correspondence to W. Rascher.

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Rascher, W., Kiess, W. & Körner, A. Bluthochdruck bei Adipositas im Kindes- und Jugendalter. Bundesgesundheitsbl. 56, 492–499 (2013). https://doi.org/10.1007/s00103-012-1638-5

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