Kidney Week 2025 Annual Meeting-A Lifespan Approach to Pediatric Hypertension: Guiding Care from Youth to Adulthood

Video Transcription

Video Summary

The session “A Lifespan Approach to Pediatric Hypertension” focused on why pediatric blood pressure (BP) screening matters, why it often fails in practice, what we know about long-term outcomes, and how to improve management and transition to adult care.<br /><br />Speakers emphasized that childhood hypertension is not benign. Newer population-based studies show children diagnosed with hypertension have higher risks later for major adverse cardiac events and kidney outcomes, plus increased healthcare utilization and costs. Hypertension in youth also tracks into adulthood; much of the adult cardiovascular risk appears mediated through persistent adulthood hypertension, suggesting early identification and control could change trajectory. However, major evidence gaps remain: the USPSTF still finds insufficient proof that screening improves hard long-term outcomes, and optimal pediatric BP thresholds are still largely percentile/statistics-based rather than outcome-based, with emerging data suggesting risk may begin below current cutoffs.<br /><br />Implementation challenges were highlighted: inaccurate or inconsistent measurement, difficulty interpreting pediatric percentiles, failure to repeat/confirm elevated readings, and poor guideline adherence for follow-up. Proposed solutions included EHR alerts, standardized protocols, staff training, validated devices, remote/home BP monitoring integration, and implementation-science approaches within learning health systems and transdisciplinary teams. The American Heart Association’s CKM (cardiovascular–kidney–metabolic) framework was presented as a useful lifespan model.<br /><br />Management updates stressed comprehensive history-taking (NICU stay even in term infants, diet sodium/processed foods, inactivity, screen time, sleep/OSA, adverse childhood experiences, anxiety/depression, vaping/nicotine pouches), motivational interviewing, and multidisciplinary lifestyle support. Emerging adult antihypertensive drug classes were reviewed, along with strategies like low-dose combination therapy.<br /><br />Finally, transition from pediatric to adult care was framed as high-risk, especially for asymptomatic hypertension, requiring structured readiness assessment tools, early preparation, and clear transfer summaries to prevent loss to follow-up and medication nonadherence.

Asset Subtitle

Moderator(s): Joshua Samuels, Christine Sethna

Presentation(s):

Improving Pediatric Hypertension Screening in Primary Care: Challenges and Strategies - Andrew South
Long-Term Kidney, Cardiovascular, and Cognitive Effects of Pediatric Hypertension - Rahul Chanchlani
New Advances in Evaluation and Management of Pediatric Hypertension - Tammy Brady
Navigating the Shift: Effective Transition Strategies for Children with Hypertension - Joyce Samuel

Meta Tag

Date 11/6/2025

Pathway 1 Pediatric Nephrology

Pathway 2 Hypertension and Cardiorenal Disorders

Session ID 504306

Keywords

pediatric hypertension

blood pressure screening

pediatric BP percentiles

USPSTF evidence gaps

long-term cardiovascular outcomes

major adverse cardiac events (MACE)

kidney outcomes

hypertension tracking into adulthood

EHR alerts and clinical decision support

standardized BP measurement protocols

home/remote blood pressure monitoring

learning health systems implementation science

AHA CKM framework (cardiovascular-kidney-metabolic)

motivational interviewing and lifestyle intervention

transition to adult care readiness assessment