August 3, 2004
Phone: (504) 865-5714
Although cardiovascular disease most frequently affects people past the age of 50, precursors to the disease begin in childhood.
So it's worrisome that the prevalence of high blood pressure in American children and adolescents increased significantly in the short period between 1988 and 2000.
High blood pressure in childhood is associated with hypertension in adulthood, which is a significant risk factor for stroke, heart attack and other cardiovascular diseases.
Several years ago, Paul Muntner examined blood pressure data from the third National Health and Nutrition Examination Survey, which was conducted between 1988 and 1994, and included 3,500 children and adolescents.
Looking at that data, Muntner, an assistant professor of epidemiology, found a higher prevalence of hypertension among black and Mexican-American children and adolescents compared to their white counterparts.
He was the first to show this distinction of Mexican-Americans. But the public health community really took notice when Muntner looked at the numbers from the health and nutrition survey sample taken in 1999 and 2000 and compared them with the earlier data.
In a decade, the average systolic blood pressure of children and adolescents between the ages of 8 and 17 went up by 1.4 millimeters of mercury and the average diastolic blood pressure went up 3.3 millimeters of mercury. The findings were published in the May issue of the Journal of the American Medical Association and attracted the attention of the national media.
"That would seem like a small change in an individual, but in a population it's significant," said Muntner. "Previous studies, including some from Dr. [Gerald] Berenson's group, show that a one- to two-millimeter increase is associated with a 10 percent increased chance of developing high blood pressure as an adult."
Berenson directs the long-running Bogalusa Heart Study and is a professor of epidemiology at Tulane. "The results we saw were extremely consistent,"Muntner added. "An increase in blood pressure was seen in boys and girls, whites, blacks and Mexican-Americans."
He wasn't surprised by the results, since American children are becoming increasingly overweight, which is the primary cause of the jump in blood pressure. "We're seeing a lot of things come together. There's a decrease in physical activity combined with greater consumption of sugar and processed food."
The National Heart Lung and Blood Institute will be incorporating the data into new guidelines for treating young people with high blood pressure. For adults and children, lifestyle changes including exercise, weight loss and reduction of sodium intake are the preferred ways to reduce blood pressure. But adults also are commonly prescribed medication to lower blood pressure.
Whether or not those medications should be prescribed to children with high blood pressure is a question that remains under debate.
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org