WebMD Medical News
Elizabeth Klodas, MD, FACC
Oct. 13, 2010 -- If new figures are to be believed, as many as one in five West Virginia fifth-graders have high blood pressure, putting them at risk for heart attack and stroke as adults.
School-based testing of more than 62,000 mostly 10- and 11-year-olds revealed that almost 20% had blood pressure readings that were high for their age, sex, and height.
It is not known how many children nationwide have high blood pressure, or even if the 20% figure is accurate for West Virginia because of the many challenges associated with school-based blood pressure testing, researchers say.
But the findings make it clear the obesity epidemic has brought with it risk factors for heart disease rarely seen in children just a few decades ago, according to University of Ottawa professor of medicine Rhian M. Touyz, MD, PhD.
Touyz chairs the American Heart Association’s High Blood Pressure Research 2010 Scientific Sessions, being held in Washington D.C. today through Saturday.
“The bottom line is we should be paying more attention to blood pressure in children,” she tells WebMD. “The fact that they saw hypertension in this many children in West Virginia is cause for concern. Even if the actual number is lower, we still need better strategies for addressing this problem.”
The death rate from heart disease is roughly 20% higher in West Virginia than the national average. Adults and children in the state are among the most obese in the nation.
In an effort to better understand the impact of obesity on cardiovascular risk in kids, West Virginia health officials implemented one of the most extensive school-based screening programs in the country more than a decade ago.
Since its inception in 1998, the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project has screened more than 100,000 school children in the state.
In a presentation at the American Heart Association meeting, CARDIAC Project co-founder Valerie E. Minor, RN, discussed the challenges of conducting cardiovascular screening in schools, including finding enough qualified people to do the testing and making sure each child is tested with the appropriate-sized blood pressure cuff.
“Normal” blood pressure for children is not the same as “normal” blood pressure for adults.
A child’s age, sex, and height are all factored in when a child’s blood pressure is taken, and children usually require smaller blood pressure cuffs than adults.
Minor says the finding that close to 20% of screened fifth-graders had high blood pressure is probably “not too far off the mark” for preteens in the state and other states with high childhood obesity rates.
Despite the challenges of school-based blood pressure screening, she says other states should consider doing it.
The American Heart Association recommends annual blood pressure monitoring for children. But with the exception of West Virginia, this rarely happens outside the pediatrician’s office, she says.
“Schools are the ideal places to screen because that’s where the kids are,” she tells WebMD. “If everyone agreed that school-based screening was worth doing, many of the problems we have experienced would be addressed.”
While the long-term impact of developing high blood pressure so early in life remains to be seen, Touyz says the predictions are dire. “It is now believed that thanks to the obesity epidemic, this may be the first generation where the life span of parents may be greater than their children.”
Minor agrees. “A 20-year-old who has been hypertensive since age 10 has had high blood pressure beating against his arteries for a decade,” she says. “We wouldn’t let an adult go a decade with high blood pressure without addressing it.”
More extensive blood pressure screening of kids would help identify those most likely to benefit from lifestyle interventions to lower risk, Minor says.
“We are not talking about treating kids with medication,” she says. “We are talking about interventions to make them more active and thinner.”
SOURCES:American Heart Association High Blood Pressure Research 2010 Scientific Sessions, Oct. 12, 2010.Valerie E. Minor, RN, MSN, associate professor of nursing, West Virginia University, Morgantown.Rhian M. Touyz, MD, PhD, senior scientist, Ottawa Hospital Research Institute; professor of medicine, University of Ottawa.News release, American Heart Association.
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