This Article Full Text Full Text (PDF) All Versions of this Article: 53/6/905    most recent HYPERTENSIONAHA.109.130070v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Falkner, B. Articles by DeLoach, S. Search for Related Content PubMed PubMed Citation Articles by Falkner, B. Articles by DeLoach, S. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Obesity Other hypertension Clinical Studies

(Hypertension. 2009;53:905.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Refining the Blood Pressure Phenotype in Children

When Does Target Organ Damage Begin?

From the Department of Medicine, Thomas Jefferson University, Philadelphia, PA.

Correspondence to Bonita Falkner, MD, Thomas Jefferson University, 833 Chestnut St, Suite 700, Philadelphia, PA 19107. E-mail Bonita.Falkner@jefferson.edu

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

Recent publications on blood pressure (BP) in children and adolescents report evidence that the prevalence of childhood hypertension is increasing,^1,2 and the increasing rates of hypertension are largely attributable to the childhood obesity epidemic. The current estimates on the prevalence of childhood hypertension, based on repeated BP measurements 95th percentile (for sex, age, and height), are 3.2% to 3.6%.^3,4 The prevalence of prehypertension, using the same method of repeated BP measurements, is 3.4% throughout childhood,³ with even higher rates among adolescents.⁴ These reports and others consistently document a significant effect of obesity on BP level throughout childhood. BP levels that are in the prehypertension range as well as in the hypertension range are considered high-risk BP levels. The combined child high BP risk of hypertension plus prehypertension now approaches 7%, a prevalence that ranks high BP as a leading childhood health issue.

The report in this issue by Lurbe et al⁵ provides a novel view of the childhood obesity-BP relationship. Because of BP variability in the young, BP status is best characterized by multiple BP measurements. These investigators used ambulatory BP monitoring achieve a more rigorous ascertainment of the BP phenotype in a total of 422 children 10 to 18 years of age. Children with clinical hypertension were excluded, and all participants were considered healthy. The children were then stratified to normal weight and obese groups and then subgrouped by normal birth weight and low birth weight. Developing ambulatory BP monitoring data on 422 healthy children is a substantial achievement. . . . [Full Text of this Article]