The joint statement is a synergistic action between HyperChildNET and the European Academy of Pediatrics about the diagnosis and management of hypertension in youth, based on the European Society of Hypertension Guidelines published in 2016 with the aim to improve its implementation. Arterial hypertension is not only the most important risk factor for cardiovascular morbidity and mortality, but also the most important modifiable risk factor. Early hypertension-mediated organ damage may already occur in childhood. The duration of existing hypertension plays an important role in risk assessment, and structural and functional organ changes may still be reversible or postponed with timely treatment. Therefore, appropriate therapy should be initiated in children as soon as the diagnosis of arterial hypertension has been confirmed and the risk factors for hypertension-mediated organ damage have been thoroughly evaluated. Lifestyle measures should be recommended in all hypertensive children and adolescents, including a healthy diet, regular exercise, and weight loss, if appropriate. If lifestyle changes in patients with primary hypertension do not result in normalization of blood pressure within six to twelve months or if secondary or symptomatic hypertension or hypertension-mediated organ damage is already present, pharmacologic therapy is required. Regular follow-up to assess blood pressure control and hypertension-mediated organ damage and to evaluate adherence and side effects of pharmacologic treatment is required. Timely multidisciplinary evaluation is recommended after the first suspicion of hypertension. A grading system of the clinical evidence is included.

1st Department of Pediatrics Aristotle University of Thessaloniki Hippokratio General Hospital of Thessaloniki Thessaloniki Greece

Analog Devices Inc Paterna Spain

CIBER Fisiopatología de Obesidad y Nutrición Instituto de Salud Carlos 3 Madrid Spain

Department of Medical Clinical Pharmacology and Department of Medicine University of Debrecen Debrecen Hungary

Department of Nephrology and Arterial Hypertension The Children's Memorial Health Institute Warsaw Poland

Department of Paediatrics Larnaca General Hospital Larnaca Cyprus

Department of Pediatric Consorcio Hospital General University of Valencia Valencia Spain

Department of Pediatric Nephrology and Hypertension Pediatric Institute Jagiellonian University Medical College Cracow Poland

Department of Pediatric Nephrology Evelina London Children's Hospital Guys and St Thomas' NHS Foundation Trust London United Kingdom

Department of Pediatrics University Hospital Ostrava Ostrava Czech Republic

Division of Pediatric Nephrology Center for Pediatric and Adolescent Medicine Heidelberg University Hospital Heidelberg Germany

Division of Pediatric Nephrology University Children's Hospital Charles University Prague Czech Republic

Institute of Medical Sciences Medical College Rzeszów University Rzeszow Poland

Institute of Pediatrics of Southern Switzerland Ente Ospedaliero Cantonale Bellinzona Switzerland

Istanbul University Cerrahpaşa Cerrahpaşa Faculty of Medicine Istanbul Turkey

Klinik für Kinderheilkunde 2 Zentrum für Kinder und Jugendmedizin Universitätsklinikum Essen Universität Duisburg Essen Essen Germany

Pediatric Center Institute of Clinical Medicine Vilnius University Vilnius Lithuania

School of Medicine European University Cyprus Nicosia Cyprus

University Hospital of Bellvitge IDIBELL and Department of Clinical Sciences University of Barcelona Barcelona Spain

University of Milano Bicocca Milano Italy

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