High Blood Pressure May Have Worse Affect on Younger Black Children

Research led by Joseph Flynn, MD, MS of Seattle Children’s Hospital and the University of Washington and a team of researchers from Johns Hopkins Children's Center finds that high blood pressure may affect younger black children worse than other children of the same age.

Hypertension, or persistently high blood pressure, may lead to worse heart trouble for black children under the age of 13 than for other children of the same ages. This is according to research led by Joseph Flynn, MD, MS of Seattle Children’s Hospital and the University of Washington and a team of researchers from Johns Hopkins Children's Center. Their study will be published in the November issue of Pediatrics.

Dr. Flynn and his co-authors analyzed data from 184 children and young adults, 45 of them black, ages 3 to 20, treated at three hospitals for primary hypertension. They found that black children were, overall, more likely to suffer from left-ventricular hypertrophy, a dangerous thickening of the heart muscle, and an early and common complication of hypertension. In particular, children younger than 13 years of age were more than twice as likely to have thickening of the heart muscle (56 percent) than children of other races (26 percent).

The researchers also found that black teen-agers had more severe hypertension than teens from other races. Not only did black teens have higher blood pressure overall, but their blood pressures remained in the dangerously hypertensive range for longer periods compared to other children. In black teens, 57 percent of the readings for systolic blood pressure (top number) recorded over 24 hours were dangerously elevated compared to 41 percent for other teens. Nearly 30 percent of the diastolic pressure (bottom number) measurements during 24 hours were abnormally high in black teens, compared to 19 percent in teens from other races.

“This study emphasizes the need for early diagnosis and prompt treatment of high blood pressure in all children, regardless of race and age, but pediatricians should be aware that black patients may develop more severe complications or develop them more quickly," said Dr. Flynn. “All children diagnosed with hypertension should be referred to a pediatric hypertension specialist and have an echocardiogram (heart ultrasound) to check the heart muscle thickness and function,” Dr. Flynn added.

The researchers say that the number of children in the U.S. that are estimated to have hypertension has increased five-fold over the last 30 years. Today more than 4 million children in the U.S. are thought to have hypertension, in large part due to the increasing prevalence of childhood obesity, among other factors.

Co-investigators from Johns Hopkins Children's Center include Tammy Brady, MD, MHS, Barbara Fivush, MD and Rulan Parekh, MD, MS.

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