The Emerging Epidemic of Hypertension in Asian Children and Adolescents

Abstract

Hypertension has become a serious global public health burden because of its high incidence and concomitant risk of cardiovascular disease. Many studies have verified that risk factors, such as hypertension and obesity which are responsible for cardiovascular disease, start in early childhood. In Asian countries, the prevalence of hypertension in the pediatric age group has become more prevalent than ever before with the increasing obesity epidemic. To tackle the epidemic of cardiovascular disease, a leading cause of death and disability of non-communicable diseases in Asian countries, population-based measures aiming at reducing harmful environmental factors to blood pressure and body weight must be applied to individuals in their early childhood, as early as the fetal stage. This review focused on the prevalence of pediatric hypertension in Asian countries and outlined several considerations for accurate blood pressure (BP) measurement and evaluation, along with an overview of pathophysiology of fetal programming and obesity related with childhood hypertension.

Risk factors and predictive biomarkers of early cardiovascular disease in obese youth

“…Hypertension has long been recognized as a vital risk factor in the development of CVD, and blood pressure monitoring in adults is an important focus of CVD prevention. 33 With the rising prevalence of 11 Rising prevalence of childhood hypertension Moore et al 12 Correlation between BMI ≥ 95th percentile and increased BP among public school students in Anadarko, Oklahoma Cao et al 13 Overweight and obese girls and boys are 11 and eight times more likely to have hypertension compared with normal weight adolescents Lo et al 14 Threefold increase in risk of hypertension when comparing severe with moderate obesity Dyslipidaemia May et al 15 and Herouvi et al 16 Increase in total cholesterol, LDL, and triglyceride levels and lower HDL level in obese youth Elmaoğullari et al 17 42.9% of 823 obese patients aged between 2 and 18 years had dyslipidaemia, particularly hypertriglyceridaemia Son et al 18 Serum levels of cholesterol precursors are higher in overweight and obese children Juhola et al 19 Abnormal lipid levels in childhood is strongly associated with abnormal levels in adulthood…”

Blood pressure-to-height ratio for diagnosing hypertension in adolescents

“…Appropriate early-stage diagnosis and intervention in children and adolescents are important for reducing the risk of hypertension-related disorders in adults. 8,9 Identifying hypertension in children and adolescents is more complicated than in adults. 1,2 Diagnosis of hypertension in children and adolescents, according to the NHBPEP Working Group on Children and Adolescents, is influenced by age, sex, and height.…”

Primary Pediatric Hypertension: Current Understanding and Emerging Concepts

“…Current epidemiological data suggest that at least 1 in 10 children is prehypertensive, while 4 in 100 children are hypertensive [2]. This substantial upsurge is attributed to the obesity epidemic and high salt intake, risk factors similar to those for adult primary hypertension [2–5, 6•]. According to the World Health Organization, adult hypertension is the leading risk factor for morbidity in middle-income countries and second only to tobacco smoking in low and high-income countries.…”

“…In the USA, the prevalence of hypertension in obese children is 11% in 2013 [5]. Comparable prevalence of pediatric hypertension and its risk factors are also seen in Asia [6•]. There has been a 0.19% increase per year in the prevalence of hypertension, adjusted for height, among Chinese children in the past 20 years [7].…”

“…There has been a 0.19% increase per year in the prevalence of hypertension, adjusted for height, among Chinese children in the past 20 years [7]. The increasing prevalence of hypertension in children may not be related solely to increasing obesity [2–5, 6•, 7]. …”