High blood pressure is a major risk factor for cardiovascular disease and stroke. Data indicate that the prevalence of high blood pressure in children and adolescents has been on the rise since 1988, with African-American and Hispanic youths at greater risk. This is especially concerning since children with elevated blood pressure are more likely to have hypertension as adults. Further, increased atherosclerosis at higher blood pressure levels has been observed in the young. The following studies investigate the development, evaluation, and treatment of elevated blood pressure in pediatric populations.
The Impact of Malaria in Pregnancy on Changes in Blood Pressure in Children During Their First Year of Life
Fetal and early postnatal growth have been associated with blood pressure in adolescents and adults. Malaria, which is hyperendemic in Nigeria, is associated with a reduction in birth weight and early growth. This study of infants in Nigeria found that exposure to malaria while in utero correlated with sex-dependent effects on blood pressure that were independent of infant growth, from birth to 1 year of age.
Carotid Artery Intima-Media Thickness and Distensibility in Children and Adolescents
Carotid artery intima-media thickness (cIMT) has been used extensively to assess early, subclinical cardiovascular disease in children and young adults with known risk factors. Here, the authors establish reference data for cIMT and carotid artery distensibility in an international, healthy cohort of children and adolescents aged 6 to 18 years, which revealed a high impact of age, body dimensions, and blood pressure.
Combined Effects of Child and Adult Elevated Blood Pressure on Subclinical Atherosclerosis: The International Childhood Cardiovascular Cohort Consortium
While elevated blood pressure levels in childhood have been linked with future target-organ damage, less is known about whether these effects are reversible if blood pressure levels normalize by adulthood. This study of four cohorts from the International Childhood Cardiovascular Cohort Consortium found that participants with elevated childhood blood pressure and normal blood pressure in adulthood did not have a significantly higher risk of increased cIMT compared with individuals with persistently normal blood pressure.
Altered Genes Profile of Renin–Angiotensin System, Immune System, and Adipokines Receptors in Leukocytes of Children With Primary Hypertension
It is known that the renin-angiotensin system (RAS) is integral to blood pressure regulation, and a growing body of data indicating roles for both the innate and adaptive immune systems. This study highlights changes in the expression of RAS genes and CD14 in the peripheral blood leukocytes of children with primary hypertension after six months of lifestyle interventions, which also lowered blood pressure and normalized metabolic abnormalities.
Physical Activity and Blood Pressure in Primary School Children: A Longitudinal Study
The ability of physical activity to directly reduce blood pressure in adults has been well recognized, but less is known about this relationship in children. This study analyzed data from the predominantly South Asian cohort in the Birmingham healthy Eating and Active lifestyle for CHildren Study and found increased physical activity levels were associated with lower blood pressure in children as young as 5, independent of weight status.