NEWS TIPS FROM THE 2009 ANNUAL MEETING OF THE PEDIATRIC ACADEMIC SOCIETIES, MAY 2-5, BALTIMORE
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 (LVH), 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 with hypertension, ages 3 to 21, 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, M.D., 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 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 says. 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); in children with chronic kidney disease, and in those who have family history of hypertension and cardiovascular disease.
Co-investigators on the study: Barbara Fivush, M.D., and Tammy Brady, M.D., M.H.S., of Johns Hopkins Children's; and Joseph Flynn, M.D., M.S., of Seattle Children's Hospital.