Introduction and objective: Evaluation of subclinical inflammation in patients with primary hypertension (PH) and white coat hypertension (WCH). Materials and methods: In 56 untreated paediatric patients with PH, 40 with WCH, and 30 healthy individuals (control group, CG), we evaluated high sensitivity C-reactive protein (hsCRP), interleukin 18 (IL-18) levels, complete blood count-derived markers of inflammation, office and ambulatory blood pressure, and selected clinical and biochemical parameters. Results: hsCRP was significantly higher in PH patients compared to CG, and neutrophil and monocyte counts were significantly higher in PH and WCH patients compared to CG. Receiver operating characteristic analysis revealed good prognostic profiles for hsCRP, neutrophil, lymphocyte, monocyte, and platelet counts, as well as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-neutrophil ratio, and platelet-to-mean platelet volume ratio as predictors of the presence of PH. In multivariate analysis, monocyte-to-lymphocyte ratio (MLR) and platelet count (β = 0.217, β = 0.191) were significant predictors of office diastolic blood pressure Z-score, while neutrophil count predicted 24 h systolic blood pressure Z-score (β = 0.365), MLR, lymphocyte count, IL-18, and NLR predicted 24 h diastolic blood pressure Z-score (β = 0.305, β = 0.253, β = −0.197, β = −0.189), and neutrophil count together with IL-18 predicted 24 h mean arterial pressure Z-score (β = 0.210, β = −0.209). Conclusions: 1. Patients with PH and WCH are characterised by similar levels of subclinical inflammation, which are significantly higher compared to healthy peers. 2. Complete blood count-derived indices, especially neutrophil count and MLR, can serve as important adjuncts to the clinical evaluation of paediatric patients with PH.

Background/Objectives: Increased blood pressure variability (BPV) was found in adults with primary (essential) hypertension (PH) and is associated with increased cardiovascular risk. Our study aimed to analyze the relation between BPV and low-grade inflammation in children with primary hypertension. Methods: In 56 treatment-naive pediatric patients with PH (15.1 ± 2.1 years) and 30 healthy children (14.9 ± 1.4 years), we evaluated BPV: BP dipping, standard deviation (SD) of ambulatory blood pressure measurements (ABPMs), pulse pressure (PP)/systolic blood pressure ratio (24 h PP/SBP), rate–pressure index (24 h RPI), 24-h weighted BPV (24 h WSBPV, 24 h WDBV, 24 h WMAPV), coefficient of variation (24 h CoVSBP, 24 h CoVDBP, 24 h CoVMAP), ambulatory arterial stiffness index (AASI), and morning BP surge. We also analyzed indices of subclinical inflammation (markers derived from complete blood count, high-sensitivity C-reactive protein (CRP), interleukin 18), and office and ambulatory BP. Results: Patients with PH had significantly higher hsCRP, neutrophils, monocytes, and platelets, neutrophil-to-lymphocyte (NLR), platelet-to-mean platelet volume (PMPVR), and lower monocyte-to-neutrophil (MNR) ratios, and higher BPV: 24 h ABPM SBP SD, 24 h ABPM MAP SD, 24 h RPI, 24 h WSBPV, 24 h WDBV, 24 h WMAPV, and 24 h CoVSBP. Low-grade inflammation markers correlated with BPV indices in both groups. In multivariate analysis, MNR predicted 24 h ABPM MAP SD (beta = 0.290, 95CI: 0.029–0.551), 24 h RPI (beta = −0.348, 95CI: −0.587–−0.108), and 24 h WDBPV (beta = 0.286, 95CI: 0.032–0.540); monocyte count—24 h RPI (beta = 0.281, 95CI: 0.041–0.521), and hsCRP—24 h WDBV (beta = 0.310, 95CI: 0.055–0.564). ROC analysis revealed a good diagnostic profile for lymphocyte count as a positive determinant of non-dipping status in PH children (cut-off point 2.59 [×10³/µL]). Conclusions: BPV is higher in children with PH compared to healthy peers and is associated with low-grade inflammation. MNR may be the most helpful indicator of BPV, whereas high lymphocyte count predicts the best non-dipping status in these patients.

Zaburzenia lipidowe (dyslipidemie) u dzieci były do tej pory kojarzone z uwarunkowaniami genetycznymi (np. rodzinną hipercholesterolemią). W ostatnich latach, ze względu na niekorzystne zmiany trybu życia, poza wrodzonymi postaciami dyslipidemii coraz częściej stwierdza się już u dzieci nabyte, uwarunkowane środowiskowo zaburzenia lipidowe, co niesie za sobą ryzyko rozwoju miażdżycy, a w przyszłości – wystąpienia incydentów sercowo-naczyniowych. W roku 2021 ukazały się polskie rekomendacje dotyczące diagnostyki i leczenia dyslipidemii, w których po raz pierwszy tak szeroko omówiono także populację dziecięcą. W artykule przedstawiono metabolizm lipidów i normy wskaźników lipidowych w wieku rozwojowym. Ponadto opisano najczęstsze uwarunkowane genetycznie dyslipidemie, a także postacie wtórne do chorób nerek i cukrzycy. Omówiono też sposoby leczenia zaburzeń lipidowych w wieku rozwojowym. Wszystkie dzieci z dyslipidemią wymagają postępowania niefarmakologicznego. Przedstawiono wskazania do wdrożenia farmakoterapii, najczęściej stosowane leki, dawkowanie i możliwe powikłania. Szczegółowo omówiono zasady stosowania statyn u dzieci.

Primary hypertension (PH) in children is an increasingly prevalent multifactorial disorder involving complex interactions between genetic, metabolic, neurohormonal, immune, and environmental factors. Recent studies highlight the potential role of gut microbiota composition and immune dysregulation in the development and progression of PH and hypertension-mediated organ damage (HMOD) in children. The gut microbiota strongly influences immune responses and vascular function through its metabolites, such as short-chain fatty acids (SCFAs), which help maintain the intestinal barrier and modulate inflammation. Conversely, dysbiosis, defined as reduced microbial diversity and increased proinflammatory taxa, can exacerbate systemic inflammation and hypertension. Immune mechanisms, including T helper 17 (Th17) cell polarization and impaired regulatory T cell (Treg) function, facilitate sodium retention, endothelial dysfunction, and organ remodeling. This narrative review summarizes current knowledge of gut microbiota alterations and immunological pathways in pediatric PH, emphasizing the potential of inflammatory markers as early biomarkers. The review also discusses how lifestyle factors such as diet and physical activity modify the gut microbiota-immune axis and blood pressure regulation. Additionally, the study highlights gaps in current knowledge and possible directions for further research. Understanding these pathways offers promising opportunities for early diagnosis, risk stratification, and novel therapeutic interventions to prevent long-term cardiovascular complications in hypertensive children.

The COVID-19 pandemic caused changes in the operation of children’s hospitals around the world. The prevention of the spread of infections is one of the most pressing issues faced by everyone involved in medical care. The following article reminds what the Karol and Maria Hospital for Children in Warsaw opened in 1913 did to prevent nosocomial infections. At the time, this hospital was one of the most modern in Europe, and the solutions it offered were welcomed with admiration and amazement. Even if not widely used, many of them seem relevant today.