Average blood pressure levels on rise among American children...( new data from the 1999-2000 NHANES. T...),Health

new data from the 1999-2000 NHANES. The data have been added to the childhood blood pressure database and reexamined to develop revised normative blood pressure tables. The updated tables now include the 50th, 90th, 95th, and 99th percentiles of blood pressure by sex, age, and height.

Hypertension in youngsters is based on the range of blood pressures in healthy children. The new guidelines continue to define normal blood pressure as the systolic and diastolic blood pressures that are less than the 90th percentile for that sex, age, and height. To be consistent with the latest blood pressure guidelines for adults (see footnote), the guidelines for children include a prehypertension category. Children with a systolic or diastolic pressure equal to or greater than the 90th percentile but less than the 95th percentile are considered prehypertensive. Hypertension continues to be defined as a systolic or diastolic pressure equal to or greater than the 95th percentile.

The new guidelines describe hypertension and prehypertension as significant health issues in the young due to the marked increase in the prevalence of overweight children. Overweight and high blood pressure are components of the insulin resistance syndrome, a combination of multiple risk factors for cardiovascular disease and type 2 diabetes. Therefore, the guidelines call for a comprehensive assessment of cardiovascular risk factors. The new guidelines, noting the association of high blood pressure and overweight with sleep apnea, also suggest that a history of sleeping patterns should be obtained in a child with hypertension.

Treatment for children with high blood pressure usually consists of lifestyle changes, including weight management, physical activity, and dietary changes. Drug therapy is used if needed. The revised guidelines incorporate recent research and present updated recommendations for lifestyle approaches, such as dietary changes for children and adolescents w
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Contact: NHLBI Communications Office
301-496-4236
NIH/National Heart, Lung, and Blood Institute
4-May-2004

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