Research led by the Johns Hopkins
Children's Center shows that black children with
persistently elevated blood pressure are more likely than
other hypertensive children to develop left
ventricular hypertrophy, a dangerous enlargement or
thickening of the left chamber of the heart.
LVH, over time, can lead to heart failure, heart rhythm
abnormalities and death.
In the study, black children with LVH also had higher
cholesterol levels, a trend that was
absent among children of other ethnicities, with or without
LVH.
All children with untreated hypertension, regardless
of race, are at risk for developing LVH
over time, the Johns Hopkins researchers say, but the new
findings should be heeded as an alarm by
pediatricians that black children may be at even higher
risk.
In the study of 139 children ages 3 to 21 with
hypertension, researchers found that of 35 black
children, 60 percent had developed LVH, compared to 37
percent of the 104 children of other races.
"Our study identifies black children with hypertension
as a special group who may be at
particularly high risk for heart disease as they age
because of several risk factors, and pediatricians
treating these kids should follow them very closely," said
study lead author Cozumel Pruette, a kidney
specialist at Johns Hopkins Children's.
An estimated 4 million children in the United States
have hypertension, a number that has
increased five times over the last 20 to 30 years, and
researchers say that the obesity epidemic is
one possible factor in the increase.
All children, regardless of race, who have had one
episode of elevated blood pressure during a
visit to their doctor should be monitored to make sure the
episode was isolated rather than chronic,
Pruette said. And all children who are diagnosed with
hypertension should be referred to a kidney
specialist and have an ultrasound study of the heart to
check heart muscle thickness and heart
function. Researchers recommend cholesterol checks for
children with blood pressure at or above the
95th percentile, overweight children with blood pressure
ranges in the 90th to 94th percentile (or
pre-hypertension), children with chronic kidney disease and
those who have family history of
hypertension and cardiovascular disease.
The findings were presented at the annual meeting of
the Pediatric Academic Societies, held May 2 to 5 in
Baltimore.
Co-investigators on the study are Barbara Fivush and
Tammy Brady, both of Johns Hopkins
Children's; and Joseph Flynn, of Seattle Children's
Hospital.
GO TO