Hypertension in Children and Adolescents from the Aspect of Functional Diagnosis

Overview

Functional exercise tests in hypertensive patients should be considered a „service test“ helping in the decisionon pharmacotherapy or its modification. Technical aspects as well as validity of exercise test results in childrenand adolescents are discussed. Comparing various reference values as well as our own experience it is clear thatblood pressure (BP) during exercise depends on the type of exercise, previous day load, and on the psychologicalbackground of the test. BP during exercise displays also gender and racial difference. The relative intensity (i.e.percentage of maximal load) should also be taken into account. Exercise test interpretation involves specificproblems and cannot be replaced by 24-hour blood pressure monitoring. Recommendations: 1. Exercise BP canhelp in decisions for pharmacotherapy of hypertension in children and young adults. 2. Interpretative analysis ofresults needs experience, adequate choice of exercise protocol and accurately defined reference values. 3. Inpatients with very high physical activity and borderline or high exercise BP values periodically repeated exercisetests are recommended. 4. Repeated exercise tests should also be performed in case of substantial change of BPat rest and after any change in antihypertensive medication.

Key words:
hypertension in childhood and adolescents, exercise test interpretation, exercise blood pressurereference values