Research suggests that elevated blood pressure during childhood is predictive of essential hypertension in young adulthood, increasing a person's lifetime risk of cardiovascular disease. Hypertension and overweight are linked in adults. Data collected from the National Health and Nutrition Examination Surveys (NHANES III, conducted 1988-1994, and NHANES 1999-2000) revealed that the average body mass index in children has increased, raising concerns about a possible concomitant increase in blood pressure.
Now, a follow-up study using the data from these surveys found that systolic and diastolic blood pressure levels also increased significantly in children and adolescents eight to 17 years of age-in all racial and ethnic groups-between 1988 and 2000.
The National Heart, Lung, and Blood Institute plans to issue new clinical guidelines later this year for the assessment and treatment of hypertension and prehypertension in children. Primary prevention programs designed to increase physical activity and prevent overweight can help slow the increasing rates of childhood obesity and hypertension.
Could caffeine be a culprit? African Americans, who are at higher risk than whites for hypertension as adults, already have higher systolic blood pressure levels by adolescence than whites do. Little is known about the effect of caffeine intake on teens' blood pressure, although it's considered a "preventable" risk factor for adult hypertension. An observational study comparing blood pressure levels in normotensive white and African American 15-to-19-year-olds after an otherwise sodium-restricted diet found a significant increase in systolic blood pressure in African-American teens who consumed large amounts of caffeinated soft drinks. White teens did not experience a similar increase. Increases in diastolic blood pressure weren't significant in either group. Since individual metabolism of caffeine differs, the study authors surmise that in African American teens it may directly raise systolic blood pressure. Alternatively, high soft drink consumption may be a marker for a host of lifestyle factors that increase the risk of hypertension. Further research is needed to explain factors contributing to rising blood pressure levels in this vulnerable group. -Fran Mennick, BSN, RN
Muntner P et al. JAMA 2004; 291(17): 2107-13; Savoca MR, et al. Arch Pediatr Adolesc Med 2004;158(5):473-7.