Two studies have shown that even a periodic increase in blood pressure (BP) in childhood indicates a high risk of developing hypertension in adulthood, according to the Internet publication for girls and women from 14 to 35 years old Pannochka. net Moreover, this factor should be considered no less important than overweight or obesity.

If a child has at least one blood pressure index at 95% of the upper limit of the norm or more before the end of school, the risk of hypertension in the future increases more than threefold (OR 3.1, 95% CI 2.0- 4.8).

Such data lead Dr. Wangju Tu from the School of Medicine of the University of Indiana (Indianapolis).

In another study, which was based on data from the same cohort of participants, the high likelihood of hypertension (GH) in adulthood was associated with overweight (OR 2.2, 95% CI 1.3-3.6), and the diagnosis of obesity (OR 4.4, 95% CI 2.8-6.9) in childhood. This study was conducted by the team of Dr. Sarah Watson from Riley Children's Hospital at Indiana University.

Both studies, which were presented at the meeting of the American Heart Association in New Orleans, devoted to the study of hypertension, draw the attention of the medical community to those populations in which it is possible to influence risk factors at an early stage through drug treatment and, most importantly, by changing the image life. The results of the meeting were told by Dr. Daniel Feig, Professor at the University of Alabama in Birmingham.

"The results of new studies confirm the findings of long-term observations of doctors," commented the report of scientists Dr. Elaine Urbina of the Children's Hospital of Cincinnati. According to her, the study by Dr. Tu "emphasizes the need for routine screening of blood pressure in children and identifying obesity as a risk factor for developing persistent hypertension in adulthood". She emphasizes that according to the current recommendations of the National Institutes of Health of the United States for the prevention of GB in adulthood, it is necessary to combine screening and measures to change the way of life of children.

Dr. Joshua Samuels of the University of Texas Health Science Center said: "Since we teach that hypertension in a child is considered to be a persistent (!) Increase in rates to 95% of the upper limit or higher, most GPs do not pay attention to single episodes of enhancement indicators. A study by Dr. Tu and his colleagues demonstrates to us that even single episodes of an isolated excess of one of the BP indicators are a signal of danger ".

Dr. Watson's study once again showed that "doctors should conduct routine screening for obesity in children". Dr. Urbina rightly remarked that today serious social measures are needed to prevent obesity among American youth and, accordingly, to reduce the incidence of CVD in the adult population.

Episodic increase in blood pressure.

Despite the fact that the role of persistent increase in blood pressure in children in the development of GB in adulthood has long been proven, the clinical significance of episodic, unstable increase in pressure in this plan remains poorly understood and may be underestimated by American physicians.

Dr. Tu and his colleagues examined these cohorts of 1,117 healthy white and black children (53% girls) who were enrolled in Indianapolis schools (the average age of participants in 1986 was 12.8 years). Arterial pressure in children was measured once a half-year before the end of school.

When the participants in the study were on average 33.4 years old, they were again invited for a full medical examination. Researchers diagnosed hypertension in a full-time visit to those who could come to the center, and according to electronic medical records from those who did not appear. The results of the experiment revealed 119 cases of hypertension in this cohort.

The frequency of GB was 8.6% among participants who did not have any excess in childhood. But those who have at least once registered a high index of blood pressure in school, the frequency of hypertension was as much as 18%. If in childhood a high blood pressure was registered 2 or more times, hypertension developed in 35% of cases.

"Children with an episodic increase in blood pressure should be observed more carefully, these episodes can not be ignored, especially in children who have other risk factors for hypertension, including a burdened family history and obesity," Dr. Tu wrote in his report.

"On the other hand, a persistent increase in blood pressure indicates prehypertension (borderline) or hypertension, and may require pharmacological intervention and / or a significant change in the child's lifestyle. Such children should exercise regularly, reduce the intake of table salt, and with excessive body weight - without fail, lose weight, "added the doctor.

Overweight and obesity.

Dr Tu in his work indicated that 59% of participants who were diagnosed with hypertension in adulthood had either excessive body weight or clinical obesity in childhood. Dr. Sarah Watson decided to conduct her research with the same cohort in order to "dig deeper" in this direction.

Before the end of secondary school, 68% of the participants in the study had normal weight, 16% were overweight (85-95% of the upper BMI limit, taking into account gender and age), and 16% had signs of obesity (more than 95% of the upper BMI). In the first group, the incidence of hypertension in adulthood was 6%, in the second group 14%, and in the latter group as much as 26%. Scientists subjected this data to multivariate analysis.

"The results of the analysis speak about the exceptional importance of the prevention and treatment of obesity even in childhood. Today, the focus of doctors on children diagnosed with obesity. Our results suggest that children who have a "mere" excess weight gain the result of a doubled risk of hypertension in the future. This suggests that pediatricians should undertake more aggressive interventions in terms of training and treatment of such patients, "wrote the researcher.

"It is very important that we, as pediatricians, advise our patients about the risk of GB associated with overweight, obesity, stress, unhealthy food and lack of mobility," added Dr. Watson.

Both studies should draw doctors' attention to a vulnerable population in which it is possible and necessary to combat unhealthy habits, preventing future cardiovascular problems at an early age.

medbe. en.