17 Jul Childhood High Blood Pressure Rates Increasing
Harvard School of Public Health
Professor in the Department of Biostatistics
Department of Biostatistics
Channing Laboratory 180 Longwood Avenue
Boston, Massachusetts 02115
MedicalResearch.com: What are the Main Findings of this study?
Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls.
Important risk factors for elevated BP were BMI, waist-circumference and sodium intake.
Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile
Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile
Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories.
There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls.
MedicalResearch.com: Where any of the findings unexpected?
Dr. Rosner: Over 80% of children were above the RDI for Na of 2300 mg per 2000 calories in both studies. However, there was a slight decrease in % of children > 1.5 * RDI (> 3450 mg/2000 calories) for both boys and girls (boys 38% vs. 31%; girls 40% vs. 31%).
About 70-80% of children were above the RDI for total and saturated fat intake in both studies, with a slight decline over time for boys.
MedicalResearch.com: What is the Take-Home Message for Clinicians and Patients?
Dr. Rosner: It is important to monitor blood pressure in children, since elevated bp in childhood is associated with elevated bp in adulthood, and elevated bp in adulthood is associated with increased risk of heart disease and stroke.
Important blood pressure risk factors to monitor are BMI, waist circumference and Na intake.
MedicalResearch.com: What Recommendations for Future Research do you have as a result of this study?
Dr. Rosner: An important issue would be to relate short-term changes or levels of blood pressure in children to echocardiographic findings (e.g. elevated left ventricular mass) in a large study representative of the U.S. pediatric population.
Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure: The NHANES Experience 1988–2008
Bernard Rosner, Nancy R. Cook, Stephen Daniels, and Bonita Falkner
Hypertension. 2013;HYPERTENSIONAHA.111.00831published online before print July 15 2013, doi:10.1161/HYPERTENSIONAHA.111.00831