June 03, 2014

MADRID, SPAIN – A study of more than 10 000 young boys and girls reveals that those with elevated systolic blood pressure—sufficient to be labeled prehypertensive—have a more adverse cardiovascular risk profile than those with normal blood pressure[1].

Presenting the results of the study here at the European Atherosclerosis Society 2014 Congress (EAS 2014), Dr Peter Schwandt (Atherosclerosis Prevention Institute, Munich, Germany) said that family physicians or pediatricians who identify prehypertensive children or adolescents in their clinic should be aware that these individuals are at potentially increased risk of developing early cardiovascular disease or other metabolic disorders.

The study, known as the Prevention Education Program (PEP) Family Heart Study , is a community-based prospective study for cardiovascular risk assessment that included first-grade boys and girls and their families from Nuremberg, Germany. To date, the study has more than 15 years of follow-up.

In the latest analysis, the researchers identified 5628 boys and 5213 girls participating in the study between 1993 and 2008 and measured blood pressure and its association with other cardiovascular disease risk factors. Prehypertension was defined as having a blood pressure in the 90th to 95th percentile. For the youths in the study, 14.9% of boys and 14.3% of girls were prehypertensive.

Overall, 32% of the youths with prehypertension were overweight or obese, defined as having a body-mass index >85th percentile, compared with just 7% of the children with normal blood pressures.

For males, prehypertensive boys were twice as likely as those with normal blood pressure to be overweight. In addition, the prehypertensive boys were twice as likely to have elevated LDL cholesterol, 2.5 times more likely to have elevated total-cholesterol levels, and 50% more likely to have elevated triglycerides.

Speaking during the moderated poster session, Schwandt said the "significant associations between dyslipidemia and prehypertension were slightly stronger" in boys than in girls. Girls with prehypertension were 2.4 times more likely to be overweight and have elevated LDL cholesterol compared with girls with normal blood pressure. Prehypertensive girls were twice as likely as normotensive girls to have elevated total-cholesterol levels, and they also had a 10% higher risk of elevated triglyceride levels.

Dr Gerda-Maria Haas (Atherosclerosis Prevention Institute), the senior investigator of the study, told heartwire it is recommended that children under nine years of age have their blood pressure measured by the family physician, but she cautioned that it needs to be measured carefully. Blood-pressure changes, like changes in cholesterol and body weight, track with increasing age, so one reading is not sufficient to label a child prehypertensive.

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