What is the primary cause of secondary hypertension in children?

Obstructive sleep apnea (OSA) due to tonsillar hypertrophy is indeed a primary cause of secondary hypertension in children. In children, the most common cause of secondary hypertension is related to sleep-disordered breathing, which is often associated with enlarged tonsils and adenoids. This condition leads to intermittent hypoxia during sleep, increased sympathetic nervous system activity, and ultimately higher blood pressure.

The anatomical and physiological changes associated with OSA result in elevations in blood pressure that may persist even when the child is awake. Therefore, identifying and treating OSA can be crucial in managing hypertension in pediatric patients.

While factors such as genetic predisposition, dietary sodium intake, and adrenal gland activity can contribute to hypertension, they are generally less common in pediatric populations compared to obstructive sleep apnea. This distinction emphasizes the importance of recognizing OSA as a significant underlying cause of secondary hypertension in children.