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Pathogenesis of hypertension in black and white children
G S Berenson1, L S Webber, S R Srinivasan
1Department of Medicine, LSU Medical Center, New Orleans 70112-2228.
Insights
Essential hypertension, or high blood pressure, begins in childhood. Black children have higher blood pressure and early cardiac enlargement, indicating a need for early lifestyle interventions to prevent cardiovascular disease.
Area of Science:
- Pediatric Cardiology
- Public Health
- Hypertension Research
Background:
- The Bogalusa Heart Study investigates cardiovascular risk factors in children.
- Essential hypertension prevalence differs between racial groups.
- Understanding early hypertension development is crucial for prevention.
Purpose of the Study:
- To explore the early natural history of essential hypertension in a biracial pediatric cohort.
- To identify factors contributing to higher hypertension prevalence in Black children.
- To examine early signs of cardiovascular changes associated with elevated blood pressure.
Main Methods:
- Analysis of cardiovascular risk factors in children from the Bogalusa Heart Study.
- Comparison of blood pressure levels and related biomarkers between Black and White children.
- Utilizing autopsy and echocardiographic data to assess cardiac structure.
Main Results:
- Black children exhibit higher blood pressure levels compared to White children.
- Early cardiac enlargement is observed in children with blood pressure in the 90th percentile.
- Lower plasma renin and serum dopamine beta-hydroxylase levels are noted in Black children.
- Obesity shows a weaker correlation with high blood pressure in Black children than in White children.
Conclusions:
- Anatomic changes related to high blood pressure manifest early in life.
- Differences in biomarkers may contribute to racial disparities in hypertension.
- Preventive strategies, including education on cardiovascular risk factors and healthy lifestyles, should commence in childhood.
Abstract:
Studies of cardiovascular risk factors in children conducted in the Bogalusa Heart Study provide a better understanding of the early natural history of essential hypertension. Contrasts in the biracial community of Bogalusa furnish some clues as to why essential hypertension is more prevalent in blacks. Black children tend to have higher blood pressure levels than whites. Autopsy studies and echocardiographic examinations have provided evidence of early cardiac enlargement in children and young adults with blood pressure levels in the 90th percentile. This suggests that the anatomic changes related to high blood pressure levels occur early in life. Blacks have lower plasma renin and serum dopamine beta-hydroxylase levels than whites. In general, obesity is not as closely correlated with higher blood pressure levels in black children as in white children. Prevention of hypertension should begin in early life. A major approach may be to educate children about cardiovascular risk factors and to encourage them to adopt healthy lifestyles while still young.