Blood pressure in childhood and adolescence. Results from an international collaborative study on juvenile hypertension^a

Abstract

ABSTRACT. A total of 17,130 children of both sexes born in 1964 and living in Hungary, USSR, GDR and Cuba were examined in 1977. The children were grouped in upper (U) and lower (L) blood pressure groups and 3,640 children were re‐examined in 1978–1981. The parents’age, smoking habits, marital status, the children's order of birth, number of siblings, and proportion of twins did not differ between U and L. The prevalence of hypertension and diabetes in the medical history of the children, and the prevalence of hypertension and stroke and diabetes in the medical history of the parents were significantly higher in U than in L. Signs of left ventricular hypertrophy and systolic murmurs, the magnitude of R and S waves in the ECG, and mean values of cardiothoracic and heart volume indices were higher in U than in L. Children in U were sexually more developed, taller, more obese (greater Quetelet's index and skinfold thickness) and less active physically. Average values of blood sugar and serumuric acid were also higher in U than in L. No difference was found between the two groups in the proportion of smokers and in mean cholesterol values. These differences between U and L were strengthened in comparison of children who showed repeatedly low (below the 30th percentile) or high (at or above the 70th, 90th and 95th percentile) readings in the SBP and DBP distribution curves. Since we did not find important differences when we related various factors to blood pressure taken on one or two separate occasions we emphasize the importance of casual blood pressure measurement in childhood.

Hemodynamic and Metabolic Profile in Offspring of Malignant Hypertensive Parents

“…In a multicenter study involving children and adolescents, a strong relationship was demonstrated between obesity and elevated BP in the beginning of the study that remained significant even after several years of follow-up. 3 In addition, in the Tecumseh Longitudinal Study, the authors observed a strong correlation of BP and weight at the final observation 10 years later, with the values of BP and weight observed in the first evaluation. 13 The higher BMI observed in the OMH group could be related to a larger number of women present in this group.…”

“…The idea of early identification of hypertension syndrome in human beings is attractive. 3 Studies in young normotensive subjects with a positive family history of hypertension are very attractive models for detecting early modifications and possible biological markers of arterial hypertension. Greater values of office BP and ambulatory BP, abnormalities in metabolism, and abnormal response to physiological and pharmacological stress have been demonstrated in normotensive offspring of "benign" hypertensive parents.…”

High blood pressure in children and adolescents: determinant factors

“…of Atherosclerosis in Finnish Children 9 e o International Collaborative Study Group 10 . Em nível nacional, cinco estudos ocuparam-se com os aspectos acima referidos, dois no Rio de Janeiro, em crianças de 5 a 12 anos 11 e em escolares de 6 a 9 anos de idade 12 ; outro em São Paulo 13 , em crianças de 4 a 7 anos; o quarto em Botucatu 14 , em crianças de 4 a 14 anos; e o quinto em Porto Alegre 15 , em uma população escolar de baixa renda, com idades entre 6 e 17 anos.…”

“…No início da adolescência, as meninas têm pressão arterial maior que a dos meninos, o contrário ocorrendo ao final da faixa etária 34 . Esse fenômeno pode ser atribuído ao início mais precoce da puberdade no sexo feminino 10 . Estudando uma amostra de escolares com grande participação de adolescentes, encontramos evidências que sugerem a importância de maturação biológica na determinação dos níveis de pressão arterial 15 .…”

Hipertensión renovascular en pediatría

“…Actualmentc sc reeonoce quc la hipertension arterial es una importance causa de morbirnortalidad, quc afecta a personas de todas las edades; 1 -2 SLI prcvaicncia en adultos es aproximadamente 20%^3 oscilando entre 0,6 y 11,0% en nifios 4 En pediatn'a, la hipertension secundaria ocupa un lugar preferente; en nuestra cxpcriencia 82,6% de los pacientes con hipertension arterial corresponden a una causa renal y de ellos 9% tienen origen renovascular. 5 Experiencias extranjcras han dcmostrado que las reparaciones de las lesiones arterialcs responsables dc la hipertension renovascular (HRV) tienen una evolucion muy satisfactoria, abrigando esperan/.as de un future inejor para estos pacientes de corta edad.…”