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Blood pressure for children and adolescents on the rise

The JAMA Network Journals

Blood pressure among children and adolescents has increased over the past decade, with part of the increase related to an increased prevalence of overweight, according to a study in the May 5 issue of The Journal of the American Medical Association (JAMA).

According to background information in the article, a previous study recently reported that the prevalence of overweight has increased from 11.3 percent to 15.5 percent for adolescent boys and 9.7 percent to 15.5 percent among adolescent girls between 1988-1994 and 1999-2000. The change in blood pressure among children and adolescents over that time and the role of overweight has been unknown.

Paul Muntner, Ph.D., of Tulane University, New Orleans, and colleagues examined data, including systolic and diastolic blood pressure levels, from two studies that used nationally representative samples of children and adolescents, aged 8 to 17 years. They were the third National Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994 (n = 3,496) and NHANES 1999-2000 (n = 2,086).

The researchers found that between the NHANES III and NHANES 1999-2000 surveys, systolic blood pressure levels increased an average of 1.4 mm Hg and diastolic blood pressure levels increased 3.3 mm Hg. "Significant increases in blood pressure levels were observed in all subgroups for diastolic blood pressure and in most subgroups for systolic blood pressure (non-Hispanic blacks, Mexican-Americans, boys, girls, and those aged 8 through 12 years)," the authors write.

"The increase in body mass index (BMI) during this same period accounted for some of the increase in blood pressure. Given the relationship between BMI and blood pressure and the high and unabated increase in the prevalence of overweight in the United States, the incidence of hypertension is likely to increase. Additionally, factors other than the increase in overweight among children and adolescents appear to have contributed to the increase in blood pressure over the previous decade. Confirmation of the trends observed in the current study is needed. Factors that have resulted in higher blood pressure levels among children and adolescents in the United States also need to be identified.

"Additionally, effective primary and secondary hypertension prevention programs aimed at children and adolescents that include prevention of overweight, weight loss, increased physical activity, and dietary modification need to be developed and implemented. Such interventions could have a profoundly positive impact on the prevalence of high blood pressure in the United States," the authors conclude. (JAMA. 2004;291:2107-2113. Available post-embargo at


Editor's Note: Dr. Muntner received partial support for the conduct of this study from a Scientist Development Award from the American Heart Association and a National Institutes of Health grant from the Institutional Development Award Program of the National Center for Research Resources. Co-author Dr. Jiang He received partial support for this study through a grant from the National Institutes of Health.

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