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Epidemiology of Primary Hypertension in Children

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Pediatric Hypertension

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Abstract

The prevalence of hypertension in the pediatric population has increased substantially over the last 30 years. While the concomitant obesity epidemic has played a major role in the rise of pediatric hypertension, it is now clear that multiple factors influence the development of hypertension in children and adolescents. This chapter describes the prevalence of hypertension and risk factors associated with its development. Further, it examines the immediate- and long-term effects of early hypertension along with population-based strategies which may be helpful for reversing noted trends in hypertension.

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References

  • Agu NC, McNiece Redwine K, Bell C et al (2014) Detection of early diastolic alterations by tissue Doppler imaging in untreated childhood-onset essential hypertension. J Am Soc Hypertens 8(5):303–311

    Article  PubMed  PubMed Central  Google Scholar 

  • Bagby SP (2007) Developmental hypertension, nephrogenesis, and mother’s milk: programming the neonate. J Am Soc Nephrol 18(6):1626–1629

    Article  PubMed  Google Scholar 

  • Bao W, Threefoot SA, Srinivasan SR (1995) Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa heart study. Am J Hypertens 8(7):657–665

    Article  CAS  PubMed  Google Scholar 

  • Barrington DS, Adeyemo AA, Rotimi CN (2014) Childhood family living arrangement and blood pressure in black men: the Howard University family study. Hypertension 63(1):48–53

    Article  CAS  PubMed  Google Scholar 

  • Brady TM, Fivush B, Flynn JT et al (2008) Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr 152(1):73–78

    Article  PubMed  Google Scholar 

  • Brady TM, Fivush B, Parekh RS et al (2010) Racial differences among children with primary hypertension. Pediatrics 126(5):931–937

    Article  PubMed  Google Scholar 

  • Chen X, Wang Y (2008) Tracking of blood pressure from childhood to adulthood: a systematic review and meta-analysis. Circulation 117(25):3171–3180

    Article  PubMed  PubMed Central  Google Scholar 

  • Cheung EL, Bell CS, Samuel JP et al (2017) Race and obesity in adolescent hypertension. Pediatrics. doi:10.1542/peds.2016-1433

  • Chockalingam A, Camplbell NR, Fodor JG (2006) Worldwide epidemic of hypertension. Can J Cardiol 22(7):553–555

    Article  PubMed  PubMed Central  Google Scholar 

  • de Moraes AC, Lacerda MG, Moreno LA et al (2014) Prevalence of high blood pressure in 122,053 adolescents: a systematic review and meta-regression. Medicine 93(27):e232

    Article  PubMed  PubMed Central  Google Scholar 

  • de Simone G, Devereux RB, Daniels SR et al (1995) Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 25(5):1056–1062

    Article  PubMed  Google Scholar 

  • Dodoo SN, Benjamin IJ (2017) Genomic approaches to hypertension. Cardiol Clin 35(2):185–196

    Article  PubMed  Google Scholar 

  • Domingos TB, Pereira AF, Yokoo EM et al (2016) Low fruit consumption and omission of daily meals as risk factors for increased blood pressure in adults. Br J Nutr 116(4):683–691

    Article  CAS  PubMed  Google Scholar 

  • Dwyer-Lindgren L, Mackenbach JP, van Lenthe FJ et al (2017) Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995–2012. Popul Health Metr. doi:10.1186/s12963-017-0133-5

  • Ehret GB, Caulfield MJ (2013) Genes for blood pressure: an opportunity to understand hypertension. Eur Heart J 34(13):951–961

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ehret GB, Munroe PB, Rice KM et al (2011) Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Nature 478(7367):103–109

    Article  CAS  PubMed  Google Scholar 

  • Falkner B (2017) Does potassium deficiency contribute to hypertension in children and adolescents? Curr Hypertens Rep. doi:10.1007/s11906-017-0733-2

  • Falkner B, Gidding SS, Portman R et al (2008) Blood pressure variability and classification of prehypertension and hypertension in adolescence. Pediatrics 122(2):238–242

    Article  PubMed  Google Scholar 

  • Falkner B, Hulman S, Kushner H (1992) Hyperinsulinemia and blood pressure sensitivity to sodium in young blacks. J Am Soc Nephrol 3(4):940–946

    CAS  PubMed  Google Scholar 

  • Falkner B, Kushner H (1990) Effect of chronic sodium loading on cardiovascular response in young blacks and whites. Hypertension 15(1):36–43

    Article  CAS  PubMed  Google Scholar 

  • Giskes K, van Lenthe FJ, Turrell G et al (2008) Socioeconomic position at different stages of the life course and its influence on body weight and weight gain in adulthood: a longitudinal study with 13-year follow up. Obesity 16(6):1377–1381

    Article  PubMed  Google Scholar 

  • Gopinath B, Baur LA, Wang JJ (2010) Blood pressure is associated with retinal vessel signs in preadolescent children. J Hypertens 28(7):1406–1412

    Article  CAS  PubMed  Google Scholar 

  • Hansen ML, Gunn PW, Kaelber DC (2007) Underdiagnosis of hypertension in children and adolescents. JAMA 298(8):874–879

    Article  CAS  PubMed  Google Scholar 

  • Hardy ST, Holliday KM, Chakladar S et al (2017) Heterogeneity in blood pressure transitions over the life course: age-specific emergence of racial/ethnic and sex disparities in the United States. JAMA Cardiol. doi:10.1001/jamacardio.2017.0652

  • He FJ, MacGregor GA (2006) Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension 48(5):861–869

    Article  CAS  PubMed  Google Scholar 

  • He FJ, MacGregor GA (2009) A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 23(6):363–384

    Article  CAS  PubMed  Google Scholar 

  • Herouvi D, Karanasios E, Karayianni C et al (2013) Cardiovascular disease in childhood: the role of obesity. Eur J Pediatr 172(6):721–732

    Article  PubMed  Google Scholar 

  • Janssen I, LeBlanc A (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. doi:10.1186/1479-5868-7-40

  • Johnson RJ, Seqal MS, Sautin Y et al (2007) Potential role of sugar (fructose) in the epidemic of hypertension, obesity, and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr 86(4):899–906

    CAS  PubMed  Google Scholar 

  • Jones DW, Chambless LE, Folsom AR et al (2002) Risk factors for coronary heart disease in African Americans: the atherosclerosis risk in communities study, 1987–1997. Arch Intern Med 162(22):2565–2571

    Article  PubMed  Google Scholar 

  • Kaczmarek M, Stawinska-Witoszynska B, Krzywinska-Wiewiorowska M et al (2015) Who is at higher risk of hypertension? Socioeconomic status differences in blood pressure among Polish adolescents: a population-based ADOPOLNOR study. Eur J Pediatr 174(11):1461–1473

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelly RK, Thomson R, Smith KJ et al (2015) Factors affecting tracking of blood pressure from childhood to adulthood: the childhood determinants of adult health study. J Pediatr 167(6):1422–1428

    Article  PubMed  Google Scholar 

  • Koebnick C, Black M, Wu J et al (2013) The prevalence of primary pediatric prehypertension and hypertension in a real-world managed care system. J Clin Hypertens 15(11):784–792

    Article  Google Scholar 

  • Lande MB, Batisky DL, Kupferman JC et al (2017) Neurocognitive function in children with primary hypertension. J Pediatr 180:148–155

    Article  PubMed  Google Scholar 

  • Lande MB, Carlson NL, Roy J et al (2006) Effects of childhood primary hypertension on carotid intima media thickness: a matched controlled study. Hypertension 48(10):40–44

    Article  CAS  PubMed  Google Scholar 

  • Lin SS, Vos T, Flaxman AD et al (2010) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380(9859):2224–2260

    Google Scholar 

  • Mattes RD, Donnelly D (1991) Relative contribution of dietary sodium sources. J Am Coll Nutr 10(4):383–393

    Article  CAS  PubMed  Google Scholar 

  • McClurkin MA, Yingling LR, Ayers C et al (2015) Health insurance status as a barrier to ideal cardiovascular health for U.S. adults: data from the national health and nutrition examination survey (NHANES). PLoS One 10(11):e0141534. doi:10.1371/journal.pone.0141534

    Article  PubMed  PubMed Central  Google Scholar 

  • McGill HC Jr, McMahan CA, Malcom GT (1995) Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Pathobiological determinants of atherosclerosis in youth (PDAY) research group. Arterioscler Thromb Vasc Biol 15(4):431–340

    Article  PubMed  Google Scholar 

  • McNiece KL, Gupta-Malhotra M, Samuels J et al (2007a) Left ventricular hypertrophy in hypertensive adolescents: analysis of risk by 2004 National High Blood Pressure Education Program Working Group staging criteria. Hypertension 50(2):392–395

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McNiece KL, Poffenbarger TS, Turner JL et al (2007b) Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr 150(6):640–644

    Article  PubMed  Google Scholar 

  • Miall WE, Oldham PD (1963) The hereditary factor in arterial blood-pressure. Br Med J 1(5323):75–80

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Morimoto A, Uzu T, Fujii T et al (1997) Sodium sensitivity and cardiovascular events in patients with essential hypertension. Lancet 350(9093):1734–1737

    Article  CAS  PubMed  Google Scholar 

  • Mu J, Zheng S, Lian Q (2012) Evolution of blood pressure from adolescents to youth in salt sensitivities: a 18-year follow-up study in Hanzhong children cohort. Nutr J. doi:10.1186/1475-2891-11-70

  • Murgan I, Beyer S, Kotliar KE et al (2013) Arterial and retinal vascular changes in hypertensive and prehypertensive adolescents. 26(3):400-408

    Google Scholar 

  • National Center for Health Statistics (2011) Health, United States 2011: with special feature on socioeconomic status and health. DHHS publication, no 2012-1232

    Google Scholar 

  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114(2 Suppl 4th Report):555–576

    Article  Google Scholar 

  • Niiranen TJ, McCAbe EL, Larson MG et al (2017) Heritability and risks associated with early onset hypertension: multigenerational, prospective analysis in the Framingham heart study. BMJ. doi:10.1136/bmj.j1949

  • Ogden CL, Carroll MD, Fryar CD et al (2015) Prevalence of obesity among adults and youth: United States, 2001–2014. NCHS Data Brief 219:1–8

    Google Scholar 

  • Ogden CL, Carroll MD, Lawman HG et al (2016) Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA 315(21):2292–2299

    Article  CAS  PubMed  Google Scholar 

  • Pieruzzi F, Antolini L, Salerno FR et al (2015) The role of blood pressure, body weight, and fat distribution on left ventricular mass, diastolic function and cardiac geometry in children. J Hypertens 33(6):1182–1192

    Article  CAS  PubMed  Google Scholar 

  • Redwine KM, Acosta AA, Poffenbarger T et al (2012) Development of hypertension in adolescents with pre-hypertension. J Pediatr 160(1):98–103

    Article  PubMed  Google Scholar 

  • Roberts J, Maurer K (1977) Blood pressure levels of persons 6–74 years. United States, 1971–1974. Vital Health Stat 203:1–103

    Google Scholar 

  • Robinson RF, Batisky DL, Hayes JR et al (2004) Body mass index in primary and secondary pediatric hypertension. Pediatr Nephrol 19(12):1379–1384

    Article  PubMed  Google Scholar 

  • Rosner B, Cook N, Portman R et al (2009) Blood pressure differences by ethnic group among United States children and adolescents. Hypertension 54(3):502–508

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sandberg K, Ji H (2012) Sex differences in primary hypertension. Biol Sex Differ 3(1):7. doi:10.1186/2042-6410-3-7

    Article  PubMed  PubMed Central  Google Scholar 

  • Silverstein DM, Champous E, Aviles DH et al (2006) Treatment of primary and secondary hypertension in children. Pediatr Nephrol 21(6):820–827

    Article  PubMed  Google Scholar 

  • Simonetti GD, Raio L, Surbek D et al (2008) Salt sensitivity of children with low birth weight. Hypertension 52(4):625–630

    Article  CAS  PubMed  Google Scholar 

  • Simons-Morton DG, Obarzanek E (1997) Diet and blood pressure in children and adolescents. Pediatr Nephrol 11(2):244–249

    Article  CAS  PubMed  Google Scholar 

  • Smith-Spangler CM, Juusola JL, Enns EA et al (2010) Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis. Ann Intern Med 152:481–487

    Article  PubMed  Google Scholar 

  • Sorof JM, Alexandrov AV, Cardwell G et al (2003) Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics 111(1):61–66

    Article  PubMed  Google Scholar 

  • Stabouli S, Kotsis V, Papamichael C (2005) Adolescent obesity is associated with high ambulatory blood pressure and increased carotid intimal-medial thickness. J Pediatr 147(5):651–656

    Article  PubMed  Google Scholar 

  • Strambi M, Giussani M, Ambruzzi MA et al (2016) Novelty in hypertension in children and adolescents: focus on hypertension during the first year of life, use and interpretation of ambulatory blood pressure monitoring, role of physical activity in prevention and treatment, simple carbohydrates and uric acid as risk factors. Ital J Pediatr. doi:10.1186/s13052-016-0277-0

  • Suarez JJ, Isakova T, Anderson CA et al (2015) Food access, chronic kidney disease, and hypertension in the U.S. Am J Prev Med 49(6):912–920

    Article  PubMed  PubMed Central  Google Scholar 

  • Susic D, Varagic J (2017) Obesity: a perspective from hypertension. Med Clin North Am 101(1):139–157

    Article  PubMed  Google Scholar 

  • United States Food and Drug Administration (2016) Draft guidance for industry: voluntary sodium reduction goals: target mean and upper bound concentrations for sodium in commercially processed, package, and prepared foods. Available at https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/ucm494732.htm. Accessed 2 June 2017

  • Urbina EM (2016) Abnormalities of vascular structure and function in pediatric hypertension. Pediatr Nephrol 31(7):1061–1070

    Article  PubMed  Google Scholar 

  • Urbina EM, Khoury PR, McCoy C et al (2011) Cardiac and vascular consequences of pre-hypertension in youth. J Clin Hypertens 13(5):332–342

    Article  Google Scholar 

  • Yang Q, Zhang Z, Kuklina EV et al (2012) Sodium intake and blood pressure among US children and adolescents. Pediatrics 130(4):611–619

    Article  PubMed  Google Scholar 

  • Yoon EY, Cohn L, Freed G et al (2014) Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension. J Adolesc Health 55(1):73–78

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Children’s Nephrology and Hypertension, St. Luke’s Regional Health System, 222 North Second Street, Suite 215, Boise, ID, 83702, USA

    Karen McNiece Redwine

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  1. Karen McNiece Redwine
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Correspondence to Karen McNiece Redwine .

Editor information

Editors and Affiliations

  1. Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA

    Joseph T. Flynn

  2. Massachusetts General Hospital, Boston, Massachusetts, USA

    Julie R. Ingelfinger

  3. Children’s Nephrology and Hypertension, Boise, Idaho, St. Luke's Children's Hospital, Children’s Nephrology and Hypertension, Boise, Idaho, USA

    Karen Redwine

Section Editor information

  1. Children's Nephrology and Hypertension, St. Luke's Health Systm, 222 North 2nd St, Suite 215, 83702, Boise, ID, USA

    Karen M. Redwine MD

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Redwine, K.M. (2017). Epidemiology of Primary Hypertension in Children. In: Flynn, J., Ingelfinger, J., Redwine, K. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-31420-4_46-1

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  • DOI: https://doi.org/10.1007/978-3-319-31420-4_46-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31420-4

  • Online ISBN: 978-3-319-31420-4

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