High Blood Pressure In US Kids Going Up In Line With Obesity

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Main Category: Pediatrics / Children's Health
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Article Date: 11 Sep 2007 - 9:00 PDT

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A new US study shows that high blood pressure (HBP) and pre-high blood pressure (pre-HBP) in American children and adolescents is rising at an alarming rate, matching the rising trend in juvenile obesity. The researchers said this is an important public health concern, and call for urgent action on early prevention of obesity.

The study is published in the early online 10th September issue of Circulation, the journal of the American Heart Association (AHA) and the research team included Dr Rebecca Din-Dzietham, who is associate professor of Community Health and Preventive Medicine at Morehouse School of Medicine in Atlanta, Georgia.

The researchers reviewed evidence from 7 government surveys from 1963 to 2002 on non-institutionalized young people aged from 8 to 17, including non-Hispanic blacks and whites and Mexican Americans.

In a press statement, the AHA said that:

"The prevalence of high blood pressure and pre-high blood pressure in children and adolescents showed a downward trend between 1963 and the 1988-94 survey. But the trend began to reverse through 2002."

The scientists looked for trends in blood pressure (BP), high blood pressure (HBP) and pre-high blood pressure (pre-HBP) against measures of obesity and adjusted for sex, age, race and ethnicity. They had to do a weighted analysis (where some data are boosted) because it was not possible to do like for like comparisons across all 7 surveys and the analysis followed a complex design.

The AHA said that the results showed over 11 per cent of American children and adolescents had HBP in 1980 and while this went down to 2.7 per cent in the 1988-1994 survey the decline reversed and the percentage of children with HBP went up to 3.7 per cent in the 1999-2002 survey, the latest one to be done.

Mexican-American males showed the steepest trend with an HBP of 5.3 per cent in 1999-2002; they were included in the government surveys from 1982 onward.

The results also showed that:

• The overall BP, pre-HBP and HBP trends went downwards from 1963 to 1988 and went upward after that.
• Pre-HBP and HBP went up by 2.3 per cent (this trend was statistically significant) and 1 per cent (not statistically significant) respectively between 1988 and 1999.
• Abdominal obesity (waist measurement) rather than general obesity, partially explained the rise in HBP and pre-HBP from 1988 to 1999.
• The reversal in the downward trend in BP and HBP followed 10 years behind the rise in obesity prevalence.
• An ethnic and gender gap appeared in 1988 for pre-HBP and in 1999 for HBP.
• The ethnic gap comprised: Non-Hispanic blacks and Mexican Americans showing a greater prevalence of HBP and pre-HBP than non-Hispanic whites.
• The gender gap comprised: males having a greater prevalence of HBP and pre-HBP than females.

The researchers concluded that:

"HBP and pre-HBP in children and adolescents are on the rise. These new findings have implications for the cardiovascular disease public health burden, particularly the risk of a new cardiovascular disease transition. They reinforce the urgent call for early prevention of obesity and HBP and illustrate racial/ethnic disparities in this age group."

Din-Dzietham said that:

"Unless this upward trend in high blood pressure is reversed, we could be facing an explosion of new cardiovascular disease cases in young adults and adults."

"To reverse the upward trend at the beginning is good, and that's why we need to act now," she urged.

"High Blood Pressure Trends in Children and Adolescents in National Surveys, 1963 to 2002."
Rebecca Din-Dzietham, Yong Liu, Marie-Vero Bielo, and Falah Shamsa.
Circulation published September 10, 2007.
doi:10.1161/CIRCULATIONAHA.106.683243

Click here for Abstract.

Written by: Catharine Paddock
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