CHILDREN'S HEALTH Rise noted in blood pressure

Officials are updating guidelines for treating hypertension in children.
WASHINGTON POST
The increase in the number of American children who have become overweight or obese in the past decade has been accompanied by a disturbing rise in their blood pressure levels, researchers reported Tuesday.
An analysis of data from nationally representative surveys of more than 5,000 children found for the first time that average pediatric blood pressure rates nationwide have begun to inch up.
The increases may seem small -- 1.4 points in the top systolic reading and 3.3 in the bottom diastolic reading. But they are enough to sharply boost a child's risk of developing high blood pressure, a major risk factor for heart disease and strokes -- the nation's leading killers, experts said.
With an adult form of diabetes already increasingly being diagnosed in children, the new finding is another indication that the nation's obesity epidemic may be predisposing a generation to diseases that in the past primarily afflicted older adults, experts said.
"What we're doing is shifting this burden of disease to a younger age," said Barbara Alving, acting director of the National Heart, Lung and Blood Institute. "We see this new data as a wake-up call. It's time to pay attention to this."
Adjusting guidelines
Federal officials have begun revising the guidelines doctors use to diagnose and treat high blood pressure in children and adolescents to spur parents and physicians to screen children more aggressively and begin treating signs of trouble early.
"The obesity-related rise in blood pressure among American children is a serious health issue," Alving said. "We need to take steps to reverse this trend."
The new guidelines, which will be released this summer, will for the first time create a category of "prehypertension" for children. The document will advise that children with prehypertension be put on a diet-and-exercise regimen to lower their blood pressure.
If that fails, drugs should be prescribed. The exact blood pressure levels that classify a child as having prehypertension or hypertension vary by age, height and sex.
"We want to give our children the best possible start in life," Alving said. "That means ensuring they have a healthy blood pressure and weight. We need to teach them to be physically active and to follow a heart-healthy eating plan. Otherwise, we may be giving them an early start on heart disease."
Details of study
In the new study, researchers examined data collected from 5,582 children and adolescents between the ages of 8 and 17 during the government's ongoing National Health and Nutrition Examination Survey between 1988 and 2000.
Over that time period, the average systolic blood pressure increased from 104.6 to 106 and the average diastolic pressure rose from 58.4 to 61.7, the researchers reported in today's issue of the Journal of the American Medical Association.
"What we're seeing is a shift in the whole blood pressure distribution in children," said Paul Muntner of Tulane University, who led the study. "We may be seeing an epidemic of hypertension in the future as these children become adults."
Studies have shown that just a one- or two-point increase in blood pressure translates into a 10 percent increased risk of developing hypertension as a young adult.
"There's a lot of evidence that high blood pressure begins in childhood, and it's generally agreed that the strongest determinant of developing high blood pressure in adulthood is high blood pressure in childhood," Muntner said.