When Hypertension Grows Up: Implications for Transitioning Care of Adolescents and Young Adults With Hypertension From Pediatric to Adult Health Care Providers

  • Author Footnotes
    1 Contributed equally.
    Sai Sudha Mannemuddhu
    1 Contributed equally.
    East Tennessee Children's Hospital, Knoxville, TN

    Department of Medicine, University of Tennessee Health Science Center-College of Medicine, Knoxville, TN
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  • Author Footnotes
    1 Contributed equally.
    Ian Macumber
    1 Contributed equally.
    Department of Pediatrics, Keck School of Medicine, Division of Nephrology, Children's Hospital Los Angeles, Los Angeles, CA
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  • Joshua A. Samuels
    Department of Pediatrics, Pediatric Nephrology & Hypertension, McGovern Medical School at the University of Texas Health Science Center, Houston, TX
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  • Joseph T. Flynn
    Address correspondence to Joseph T. Flynn, MD, MS, Dr. Robert O. Hickman Endowed Chair in Pediatric Nephrology, Professor of Pediatrics, University of Washington, 4800 Sand Point Way NE, M/S O.C.9.820, Seattle, WA 98105.
    Department of Pediatrics, University of Washington, Division of Nephrology, Seattle Children's Hospital, Seattle, WA
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  • Andrew M. South
    Department of Pediatrics, Section of Nephrology, Wake Forest School of Medicine and Brenner Children's Hospital, Winston Salem, NC

    Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC

    Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston Salem, NC
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  • Author Footnotes
    1 Contributed equally.
      Hypertension (HTN) is an important cause of morbidity and mortality in children as well as adults. HTN and related adverse cardiovascular health develop and progress on a continuum across an individual's life course. Pediatric HTN, or even isolated elevated blood pressure as a child, increases the risk of sustained HTN and cardiovascular disease in later adulthood. Transitioning the care of adolescents and young adults who have HTN is an important but unmet health care need that could potentially have a dramatic effect on mitigating the risk of cardiovascular disease in adulthood. However, very little has been published about the transition process in this population, and considerable gaps in the field remain. We discuss the epidemiology, etiology, and management approach in youth with HTN and how they differ from adults. We contextualize HTN and cardiovascular health on a continuum across the life course. We discuss key considerations for the transition process for adolescents and young adults with HTN including the major barriers that exist. Finally, we review key immediate health care needs that are particularly important around the time of the transfer of care.

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