High Blood Pressure In Young Adults And Children

High blood pressure is a well-known and important risk factor for cardiovascular

diseases in adults and significantly contributes to morbidity and mortality from myocardial infarction ("heart-attack"), heart failure, peripheral vascular disease, chronic kidney disease and stroke.

It is not yet known for sure whether high blood pressure that has been diagnosed during childhood or adolescence is related to these diseases as adults.

In addition, these complications and diseases are very rare during childhood. However, there is evidence in several studies that shows a strong relation between high blood pressure and teenage atherosclerosis (fibrotic plaques within the blood vessel walls).

High blood pressure during childhood is also suggested to cause higher rates of LVH- left ventricle hypertrophy (growth), which can ultimately lead to permanent cardiac damage.

The presence of obesity has increased high blood pressure rates during childhood, and LVH as the end result.

Unfortunately, high blood pressure during childhood and adolescence is currently under-diagnosed. It is very hard to differentiate between true high blood pressure to the "White-Coat Phenomenon", which is very common in young ages.

Therefore, current clinical guidelines suggest measuring blood pressure starting at the age of 3. Because high blood pressure at a very young age is usually caused by a specific disorder (for example heart or kidney genetic malformation), it is important to diagnose the cause and start appropriate treatment as soon as possible.

Studies from the U.S showed that only 26% percent of the young patients with high blood pressure were properly diagnosed and treated. This information leads to the inevitable question- how can we actively diagnose high blood pressure at a younger age, and should we even do so?

The answer to this would be trying to understand whether active screening for high blood pressure in children and young adults would benefit the patients in the long term.

These types of prospective clinical studies are currently being held in several countries, hoping they will result in a new clinical guideline, showing exactly how and when should active screening take place.

One screening options that has been suggested is measuring blood pressure in over-weight or diabetic children and young adults. Obesity and diabetes are two very strong risk factors to developing high blood pressure in adults. Therefore it is indeed important to study the possible risk during younger age as well.

These studies have another challenge set for them- determining exactly what would be considered high blood pressure at younger age, and its' impact on the patient's morbidity and mortality during adulthood.

by: Maria Gonzales

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