Table 11.6.
Recommendations for approaching children and adolescents
| Recommendation | Recommendation class | Level of evidence | Reference | ||
|---|---|---|---|---|---|
| Blood pressure classification in children and adolescents | |||||
| Up to 13 years old | Systolic or diastolic blood pressure percentile | ||||
| Normal (1-13 years old) | < 90 | ||||
| High blood pressure | ≥ 90 to < 95 or PA 120 x 80 mmHg at < 95 (whichever is lower) |
I | B | 590-593 | |
| SAH stage 1 | ≥ 95 to < 95 + 12 mmHg or 130 x 80 mmHg to 139 x 89 mmHg (whichever is lower) |
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| SAH stage 2 | ≥ 95 + 12 mmHg or ≥ 140 x 90 mmHg (whichever is lower) |
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| Antihypertensives most frequently used in the treatment of hypertension in children and adolescents in Brazil: captopril, enalapril, hydrochlorothizide, amlodipine and losartan in children over 6 years old | I | A | 590-593 | ||
| Reference values for lipids and lipoproteins in children and adolescents | |||||
| Lipids | Fasting (mg/dL) | Not fasting (mg/dL) | |||
| Total cholesterol | < 170 | < 170 | |||
| HDL-cholesterol | > 45 | > 45 | |||
| Triglycerides (0-9 years old) (10-19 years old) |
< 75 < 90 |
< 85 < 100 |
I!a | C | 590-593 |
| LDL-cholesterol | < 110 | < 110 | |||
| Non-HDL-cholesterol | > 145 | > 145 | |||
| LDL-cholesterol targets in children and adolescents according to cardiovascular risk profile | |||||
| LDL-cholesterol levels | Risk | ||||
| < 190 mg/dL | without another risk factor | IIa | C | 590-593 | |
| < 160 mg/dL | Early coronary insufficiency in the family Or other risk factor | ||||
| < 130 mg/dL | Established coronary insufficiency OR 2 diseases or high risk factors OR 1 disease or high risk factor AND 2 diseases or moderate risk factors (Table 11.3) | ||||
| Drugs used to treat dyslipidemia in childhood and adolescence | |||||
| Medicine | Dose | Observations | |||
| Lovastatin, pravastatin, simvastatin and atorvastatin | 10-40 mg/day | Pravastatin for HIV and atorvastatin for HF (> 7years) | |||
| Rosuvastatin | 5-20 mg/day | Mainly in HF (> 7 years) |
IIa | A | 590-593 |
| Cholestyramine | 4-16 g/day | Any age | |||
| Ezetimibe | 10 mg/day | > 4 years old | |||
| Bezafibrate, fenofibrate | 200-600 mg/day | TG persistently > 500 mg/dL | |||
| Omega 3 | 2-4 g/day | Variable effect | |||
| Phytosterols | 1,2-1,5 g/day | Variable effect | |||
LDL-a: low-density lipoprotein cholesterol; SAH: systemic arterial hypertension.