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(Circulation. 2008;117:3163-3164.)
© 2008 American Heart Association, Inc.

Editorial

Measuring Children’s Blood Pressure Matters

Samuel S. Gidding, MD

From the Nemours Cardiac Center, DuPont Children’s Hospital, Wilmington, Del.

Correspondence to Samuel S. Gidding, MD, Nemours Cardiac Center, 1600 Rockland Rd, Wilmington, DE 19803. E-mail sgidding@nemours.org

Key Words: Editorials • blood pressure • hypertension • pediatrics • population

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In the 1970s, childhood, and particularly the part of childhood before adolescence, was considered a low–cardiovascular risk state. With the exception of specific conditions such as diabetes mellitus type 1, familial hypercholesterolemia, end stage renal disease, and secondary hypertension, assessment of cardiovascular risk in children seemed unnecessary. Childhood risk factor distributions were well below thresholds thought to be associated with risk for cardiovascular disease. Even today, it is not until adolescence that blood pressure classified as prehypertension by adult criteria is at the 90th percentile of the pediatric distribution.¹

Article p 3171

In the Korean War, the observation that significant atherosclerosis was present in young US soldiers dying in that conflict suggested that atherosclerosis had its origins in youth. This possibility has been dramatically confirmed by the Pathobiological Determinants in Youth (PDAY) study and the Bogalusa Heart Study where autopsy assessment of coronary and abdominal aortic atherosclerosis has been shown to relate directly to risk factors measured postmortem (PDAY) and those measured before accidental death (Bogalusa).^2,3

The recognition that atherosclerosis is a chronic disease with possible origins early in life led several pioneering investigators in the United States and around the world, beginning in the 1970s, to measure cardiovascular risk factors in youth. In addition to determining the distribution of these risk factors at young ages, an important goal of these studies was to determine if risk in youth predicted risk later in life, a concept termed "tracking," meaning that those with higher or lower risk at initial measurement would . . . [Full Text of this Article]

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