Children Learn

Hypertension Rising in Children

Hypertension is a significant problem for older adults. But now, it’s becoming a concern for children and youth. A new study in JAMA Pediatrics tells us that the global prevalence of high blood pressure is rising in children and youth. Mainly, it’s because rates of childhood obesity are rising around the world.

Eight Times More Likely with Obesity

Peige Song and colleagues conducted a systematic review and meta-analysis of hypertension in the general pediatric population. They found it was becoming more common and it was linked to growing rates of obesity. In fact, for children with overweight, the risk was two and a half times higher. With obesity, it was eight times higher.

Rates of hypertension appear to peak at the time of puberty. Later in adolescence, Song et al found somewhat lower prevalence. However, at all ages their data is clear. High blood pressure is becoming more common in children and youth. Between 2000 and 2015, prevalence rose at a relative rate of 75 to 79 percent.

A Gap in Clinical Care

Because hypertension hasn’t been much of a problem for children until now, guidelines for clinical care have some catching up to do. The American Academy of Pediatrics issued new guidelines in 2017. Those guidelines recommend diet and exercise as a first line of therapy, especially in children with overweight and obesity. Mayo Clinic advises parents: “Control your child’s weight.” It’s at the top of their list for what parents should do if a child has hypertension.

However, the evidence of effectiveness for such recommendations is weak. That’s not so different from the evidence for treating the underlying problem in children – obesity. It’s the result of not-so-benign neglect.

All the while this problem has been growing, we’ve had a near exclusive focus on prevention. Of course, we still need effective prevention strategies. However, it’s pretty clear that we don’t have them, because the problem continues to grow despite best efforts.

So now we must play catch up and start developing better strategies for treating obesity along with its complications in children. Neglect of their health is not an acceptable option.

Click here for the study in JAMA Pediatrics and here for a companion editorial. For further perspective, click here and here.

Children Learn, painting by Antonín Dvořák / Wikimedia Commons

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October 8, 2019

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