The Journal of Pediatrics
Volume 155, Issue 2 , Pages 165-169 , August 2009

Pre-hypertension and Hypertension in Pediatrics: Don't Let the Statistics Hide the Pathology

  • R. Thomas Collins II, MD

      Affiliations

    • Children's Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA
    • University of Pennsylvania School of Medicine, Philadelphia, PA
    • ,
  • Bruce S. Alpert, MD

      Affiliations

    • The University of Tennessee Health Science Center Department of Pediatrics, Memphis, TN
    • Le Bonheur Children's Medical Center, Memphis, TN

Received 29 September 2008 ,Revised 21 January 2009 ,Accepted 4 February 2009.

References 

  1. Kochanek KD, Murphy SL, Anderson RN, Scott C. Deaths: final data for 2002. Natl Vital Stat Rep. 2004;53:1–115
  2. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. Heart disease and stroke statistics—2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:E69–E171
  3. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298:874–879
  4. Bao WH, Srinivasan SR, Wattigney WA, Berenson GS. Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood: the Bogalusa Heart Study. Arch Intern Med. 1994;154:1842–1847
  5. Bao WH, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa heart study. Am J Hypertens. 1995;8:657–665
  6. Li SX, Chen W, Srinivasan SR, Berenson GS. Childhood blood pressure as a predictor of arterial stiffness in young adults: the Bogalusa Heart Study. Hypertension. 2004;43:541–546
  7. Newman WP, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Cresanta JL, et al. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. The Bogalusa Heart Study. N Engl J Med. 1986;314:138–144
  8. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338:1650–1656
  9. Burke GL, Arcilla RA, Culpepper WS, Webber LS, Chiang YK, Berenson GS. Blood pressure and echocardiographic measures in children: the Bogalusa heart study. Circulation. 1987;75:106–114
  10. Glen SK, Elliott HL, Curzio JL, Lees KR, Reid JL. White-coat hypertension as a cause of cardiovascular dysfunction. Lancet. 1996;348:654–657
  11. Cerasola G, Cottone S, Nardi E, D'Ignoto G, Volpe V, Mule G, et al. White-coat hypertension and cardiovascular risk. J Cardiovasc Risk. 1995;2:545–549
  12. Puato M, Palatini P, Zanardo M, Dorigatti F, Tirrito C, Rattazzi M, et al. Increase in carotid intima-media thickness in grade I hypertensive subjects: white-coat versus sustained hypertension. Hypertension. 2008;51:1300–1305
  13. Lande MB, Meagher CC, Fisher SG, Belani P, Wang H, Rashid M. Left ventricular mass index in children with white coat hypertension. J Pediatr. 2008;153:50–54
  14. Edmonds ZV, Mower WR, Lovato LM, Lomeli R. The reliability of vital sign measurements. Ann Emerg Med. 2002;39:233–237
  15. Pearce KA, Grimm RH, Rao S, Svendsen K, Liebson PR, Neaton JD, et al. Population-derived comparisons of ambulatory and office blood pressures—implications for the determination of usual blood pressure and the concept of white coat hypertension. Arch Intern Med. 1992;152:750–756
  16. [Anon] . The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555–576
  17. Myers MG, Haynes RB, Rabkin SW. Canadian hypertension society guidelines for ambulatory blood pressure monitoring. Am J Hypertens. 1999;12:1149–1157
  18. Report of the Second Task Force on Blood Pressure Control in Children—1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics. 1987;79:1–25
  19. Chiolero A, Cachat F, Burnier M, Paccaud F, Bovet P. Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. J Hypertens. 2007;25:2209–2217
  20. Podoll A, Grenier M, Croix B, Feig DI. Inaccuracy in pediatric outpatient blood pressure measurement. Pediatrics. 2007;119:e538–e543
  21. Sorof JM, Turner J, Martin DS, Garcia K, Garami Z, Alexandrov AV, et al. Cardiovascular risk factors and sequelae in hypertensive children identified by referral versus school-based screening. Hypertension. 2004;43:214–218
  22. McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007;150:640–644
  23. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572
  24. Collins RT, Somes GW, Alpert BS. Differences in arterial compliance among normotensive adolescent groups. Pediatr Cardiol. 2008;29:929–934
  25. United States Census Bureau. 2008 National Population Projections. http://www.census.gov/population/www/projections/2008projections.html. Accesses on 20 September 2008.
  26. Lauer RM, Clarke WR. Childhood risk factors for high adult blood pressure: the Muscatine Study. Pediatrics. 1989;84:633–641
  27. Sorof JM, Poffenbarger T, Franco K, Portman R. Evaluation of white coat hypertension in children: importance of the definitions of normal ambulatory blood pressure and the severity of casual hypertension. Am J Hypertens. 2001;14:855–860
  28. Ben Dov IZ, Kark JD, Mekler J, Shaked E, Bursztyn M. The white coat phenomenon is benign in referred treated patients: a 14-year ambulatory blood pressure mortality study. J Hypertens. 2008;26:699–705
  29. Kouidi E, Fahadidou-Tsiligiroglou A, Tassoulas E, Deligiannis A, Coats A. White coat hypertension detected during screening of male adolescent athletes. Am J Hypertens. 1999;12:223–226
  30. Verdecchia P, Schillaci G, Boldrini F, Zampi I, Porcellati C. Variability between current definitions of normal ambulatory blood pressure—implications in the assessment of white coat hypertension. Hypertension. 1992;20:555–562
  31. Waeber B, Petrillo A, Nussberger J, Hofstetter JR, Scherrer U, Bidiville J, et al. Are some hypertensive patients overtreated—a prospective study of ambulatory blood pressure recording. Lancet. 1987;2:732–734
  32. Pickering TG, James GD. Ambulatory blood pressure and prognosis. J Hypertens Suppl. 1994;12:S29–S33
  33. Alderman MH, Ooi WL, Madhavan S, Cohen H. Blood pressure reactivity predicts myocardial infarction among treated hypertensive patients. J Clin Epidemiol. 1990;43:859–866
  34. Manning G, Rushton L, Millar-Craig MW. Clinical implications of white coat hypertension: an ambulatory blood pressure monitoring study. J Hum Hypertens. 1999;13:817–822
  35. Kavey REW, Kveselis DA, Atallah N, Smith FC. White coat hypertension in childhood: evidence for end-organ effect. J Pediatr. 2007;150:491–497
  36. Urbina E, Alpert B, Flynn J, Hayman L, Harshfield GA, Jacobson M, et al. Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the council on cardiovascular disease in the young and the council for high blood pressure research. Hypertension. 2008;52:433–451
  37. Five-year findings of the hypertension detection and follow-up program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension. Hypertension Detection and Follow-up Program Cooperative Group. JAMA. 1979;242:2562–2571
  38. Couch SC, Saelens BE, Levin L, Dart K, Falciglia G, Daniels SR. The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. J Pediatr. 2008;152:494–501

 The authors declare no conflicts of interest.

PII: S0022-3476(09)00116-4

doi: 10.1016/j.jpeds.2009.02.006

The Journal of Pediatrics
Volume 155, Issue 2 , Pages 165-169 , August 2009

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