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(Hypertension. 2008;52:807.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Sleep-Disordered Breathing and Blood Pressure in Children

From the Department of Medicine, Medical University of South Carolina, Charleston.

Correspondence to Brent M. Egan, Medical University of South Carolina, 135 Rutledge Ave, RT 1230, Charleston, SC 29425. E-mail eganbm@musc.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The article by Bixler et al in this edition of Hypertension¹ adds to a growing body of evidence that risk factors associated with abdominal obesity in adults, namely, sleep-disordered breathing (apnea-hypopnea), occur in children as well. Specifically, sleep-disordered breathing appeared to be more strongly associated with waist circumference, a surrogate marker for abdominal obesity, than with body mass index, a more generalized or global obesity marker. Although body mass index in children and youth is strongly related to prevalent metabolic syndrome,² other data show that waist circumference is as good as,³ if not better than,⁴ body mass index as a predictive factor for metabolic syndrome at early ages. In adults, prevalent and incident sleep-disordered breathing are associated with body mass index.^5,6

On a positive note, the prevalence of moderate sleep-disordered breathing in children, which was associated with a major effect on systolic blood pressure of >10 mm Hg, is relatively uncommon at 1%. Although mild sleep-disordered breathing was identified in 25% of children, the systolic blood pressure effect was a more modest 2 mm Hg. Despite the lesser current blood pressure concern for the 25% of children with mild sleep-disordered breathing, evidence from the Bogalusa Heart Study indicates that children with greater levels of blood pressure and other metabolic syndrome risk factors also have a steeper trajectory of increasing risk factor values over time than children with lesser risk.⁷ Thus, future studies in children to examine changes in the apnea-hypopnea index, as well as metabolic syndrome risk factors over time, . . . [Full Text of this Article]