Hypertension in youth with metabolic syndrome

Hypertension continues to increase in its prevalence in children and adolescents globally. This evolving health issue has been associated with the concurrent world-wide rise in childhood obesity. In this review, we aim to improve the awareness of hypertension in youth with metabolic syndrome (MetS) highlighting key published data. This review examines the interplay between MetS and hypertension during childhood and adolescence, covering its epidemiology, pathophysiology, screening, diagnosis, and potential management strategies. Hypertension and obesity are integral features of MetS, which describes a clustering of metabolic risk factors hallmarked by insulin resistance that significantly increases the risk of cardiovascular disease in adulthood. Children at risk of developing hypertension and MetS share many modifiable and non-modifiable risk factors, which are derived from common pathophysiological mechanisms. Identifying at-risk individuals through targeted screening is crucial, given their long-term adverse cardiovascular outcomes in young adulthood. Management of hypertension and MetS requires a stepwise, multidisciplinary approach, central to which is the recognition that adoption of healthy lifestyle intervention over the lifespan is key to prevention, with consideration for pharmacotherapy and other medical interventions as indicated.