Related Experiment Videos
Epidemiology of early primary hypertension and implications for prevention: the Bogalusa Heart Study
G S Berenson1, W A Wattigney, W Bao
1Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112-2824.
Insights
Primary hypertension begins in childhood, as evidenced by epidemiological and echocardiographic studies. Early intervention targeting environmental factors in high-risk children can prevent future cardiovascular and renal disease.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Epidemiological studies over 20 years reveal primary hypertension originates in childhood.
- Autopsy, echocardiographic, and long-term BP studies confirm early onset of hypertension.
- Essential hypertension is identifiable in children, despite lower BP thresholds than adults.
Purpose of the Study:
- To understand the early onset of primary hypertension in children and young adults.
- To identify mechanisms and preventive strategies for childhood hypertension.
- To reduce the future incidence of hypertensive cardiovascular and renal disease.
Main Methods:
- Review of epidemiological studies on blood pressure (BP) in children and young adults.
- Analysis of autopsy and echocardiographic data.
- Long-term BP monitoring in pediatric populations.
Main Results:
- Primary hypertension is established in early childhood.
- Complex hemodynamic and metabolic factors contributing to hypertension are present in childhood.
- Hypertensive cardiovascular disease is potentially preventable through early intervention.
Conclusions:
- Early identification and intervention are crucial for preventing childhood hypertension.
- Environmental factors like diet, electrolyte intake, obesity, and activity levels are key to prevention.
- Public health initiatives and primary care programs can significantly reduce hypertension and its complications.
Abstract:
Epidemiological studies of BPs in children and young adults over the past 20 years have contributed considerably to understanding the early onset of primary hypertension. Observations from autopsies and echocardiographic studies, together with long-term BP studies, of children clearly indicate that primary hypertension begins in early childhood. Although abnormal BP levels in children are much lower than the adult criteria used for clinical diagnosis of hypertension, essential hypertension is identifiable in early life. Complex haemodynamic and metabolic mechanisms related to essential hypertension are also being identified in childhood. The development of intervention programs in an attempt to prevent hypertension in its early phases suggests hypertensive cardiovascular disease is preventable. Environmental factors (improved dietary factors, altering electrolyte intake, prevention of obesity and increased activity levels) are critical elements to prevention. Children and young adults identified as high risk for hypertension need to be targeted for prevention of early cardiovascular renal disease. Also, as hypertension is so prevalent, attempts should be made to control environmental factors in the general public. Preventive programmes established by primary healthcare physicians, paediatricians and para-professionals can have a major impact on the reduction of hypertension and its complications of cardiovascular renal disease in the future.