Childhood prevention of essential hypertension

Childhood prevention of essential hypertension requires knowledge of alterable determinants of blood pressure in children; these include obesity and sodium intake and perhaps physical activity and intake of potassium and calcium. Altering these determinants may involve two general preventive strategies. The first is a population strategy, which attempts to lower blood pressure (or keep it from rising) among all children. Population strategies may require educating children to active participants in changing their behaviors (active approach) or may merely change their environment (passive approach). The second general strategy aims to focus on children at high risk of developing hypertension as adults. To determine the usefulness of this high-risk strategy, more information is needed about prediction of adult blood pressure from childhood values and about the efficacy of interventions to control blood pressure levels in high-risk children.