Elevated blood pressure and target organ damage

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It is clear that elevated blood pressure in adults is associated with increased risk of myocardial infarction, stroke, congestive heart failure and other adverse cardiovascular outcomes. In children and adolescents, blood pressure elevation has been linked to left ventricular hypertrophy, which is associated with increased risk of cardiovascular disease in adults. In this issue of The Journal, Lim et al report on the relationship of higher blood pressure with increased carotid artery internal medial thickness (IMT) in adolescents. This is potentially important because increased carotid IMT has been associated with carotid and coronary artery atherosclerosis in adults. Lim et al found that carotid IMT increased as both systolic and diastolic blood pressure increased in girls but not boys. The reason for this difference by sex is not known. These results emphasize that higher blood pressure may have a more immediate adverse impact on the cardiovascular system in young individuals, which could result in long term morbidity or mortality.