CMAJ • August 12, 2008; 179 (4). doi:10.1503/cmaj.1080081.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Letters

Hypertension in children and adolescents

Arianna Bocelli, MD* and Piercarlo Ballo, MD{dagger}

*Meyer's Children Hospital, University of Florence, Florence, Italy; {dagger}Cardiology Operative Unit, Sant'Andrea Hospital, La Spezia, Italy

We read with great interest the recent article by Karen Tu and colleagues concerning the prevalence of hypertension in adults aged 20 years and older.1 The authors' estimate for 1995–2005 in Ontario was considerably higher than the recent estimate by Kearney and colleagues of a 24% relative increase in the prevalence of hypertension from 2000 to 2025 in developed countries.2

Din-Dzietham and colleagues recently reported a 37% relative increase in the prevalence of hypertension in American children and adolescents between 1988 and 1999.3 The upward trend was particularly evident in boys; Tu and colleagues reported a similar finding in adults.1

Although the factors underlying the increase in the prevalence of hypertension are likely to be different in adults and children, obesity is an important determinant in both groups.4,5 In a recent analysis that combined data from the Third National Health and Nutrition Examination Survey (NHANES III, conducted from 1988 to 1994) and the NHANES 1999–2000 study, obesity accounted for nearly 30% of the increase in systolic blood pressure observed in children and adolescents over a 12-year period.5 Considering the potential impact that uncontrolled hypertension and high body mass index in children could have on the epidemiology of hypertension in the future, public health strategies to prevent hypertension and reduce overweight and obesity in children and adolescents are urgently required.

Footnotes

Competing interests: None declared.


REFERENCES

  1. Tu K, Chen Z, Lipscombe LL; Canadian Hypertension Education Program Outcomes Research Taskforce. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study. CMAJ 2008;178:1429-35.[Abstract/Free Full Text]
  2. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217-23.[Medline]
  3. Din-Dzietham R, Liu Y, Bielo MV, et al. High blood pressure trends in children and adolescents in national surveys, 1963 to 2002. Circulation 2007;116:1488-96.[CrossRef][Medline]
  4. Muntner P, He J, Cutler JA, et al. Trends in blood pressure among children and adolescents. JAMA 2004;291:2107-13.[Abstract/Free Full Text]
  5. Hajjar I, Kotchen T. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA 2003;290:199-206.[Abstract/Free Full Text]




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