Hypertension Warns Heart Disease Set to Triple in Obese Teens

Article in the Journal of the American Society of Hypertension Warns Heart Disease Set to Triple in Obese Teens

A recent paper published in the Journal of the American Society of Hypertension projected that the prevalence of premature coronary heart disease (CHD) in young adulthood will more than triple from five percent to 16 percent for currently obese adolescents when they reach 35 years of age. While lifestyle changes and appropriate medications are acknowledged as imperative, the author argues that ultimately, these conventional clinical tools are unlikely to adequately protect such children and young adults from premature death due to CHD and cardiovascular events such as heart attack or stroke.

Childhood obesity is a well-established epidemic in the U.S., with more than 17% of children falling into the obese category and even more categorized as overweight. Furthermore, 30% of obese adolescents have obesity associated with high blood pressure and frequently have other risk factors including components of the metabolic syndrome, which is a cluster of risk factors including dyslipidemia, impaired glucose tolerance and hyperinsulinemia, among others. The paper calls for additional clinical research to define disease pathways, improve detection and treatment methods and determine the most beneficial time points for intervention.

"The magnitude of the cardiovascular consequences for obese children, especially those with high blood pressure, is substantial," said Bonita Falkner, MD, Thomas Jefferson University, author of the article and lead author of the Pediatric Hypertension Guidelines published in 2004. "To help prevent more serious consequences for these children later in life, early evaluation and detection of risk factors is imperative."

It is recommended that healthy children have their blood pressure measured, as part of routine health care, beginning at three years of age. Children, including children younger than three years of age, with chronic illness or unexplained symptoms should have their blood pressure measured as part of a medical evaluation. When high blood pressure is detected and verified in a child, an appropriate evaluation is indicated.

The study author provides new insights on the current pediatric hypertension guidelines through the lens of childhood obesity:
* There is now evidence that organ damage can be detected in many children with hypertension. For example, signals of organ damage like left ventricular hypertrophy, greater carotid artery intimal medial thickness and retinal arteriolar narrowing have been described in children and adolescents with high blood pressure.
* Organ damage is more common in children with high blood pressure and obesity.
* Once identified, children and adolescents with hypertension, especially obesity-associated hypertension, should be evaluated for additional risk factors including components of the metabolic syndrome and inflammatory markers such as C-reactive protein (CRP).