A recent article in the Journal of the American Society of Hypertension projects the prevalence of premature coronary heart disease (CHD) in young adulthood will more than triple—from 5% to 16%—for currently obese adolescents when they reach age 35.
While lifestyle changes and appropriate medications are acknowledged as imperative, the author argues these conventional clinical tools are ultimately unlikely to adequately protect these young adults from premature death from CHD and cardiovascular events like heart attack or stroke.
Childhood obesity is a well-established epidemic in the United States, with more than 17% of children falling into the obese category and even more categorized as overweight. Further, 30% of obese adolescents also have high blood pressure and metabolic syndrome (a pre-diabetes condition).
“The magnitude of the cardiovascular consequences for obese children, especially those with high blood pressure, is substantial,” says board-certified pediatrician and kidney specialist Bonita Falkner, MD, a professor of medicine at Thomas Jefferson University in Philadelphia and the article’s author. “To help prevent more serious consequences for these children later in life, early evaluation and detection of risk factors is imperative.”
Healthy children should have their blood pressure measured, as part of routine health care, beginning at age 3. Children with chronic illness or unexplained symptoms (including those younger than 3) should have their blood pressure measured as part of a medical evaluation. When high blood pressure is detected and verified in a child, an appropriate evaluation is indicated.
Dr. Falkner also emphasizes the following:
- There’s now evidence that organ damage can be detected in many children and adolescents with hypertension.
- Organ damage is more common in children with high blood pressure and obesity.
- Once identified, children and adolescents with hypertension, especially obesity-associated hypertension, should be evaluated for additional risk factors.
“The American Society of Hypertension echoes Dr. Falkner’s call to better understand certain disease pathways and whether inflammation contributes substantially to target organ damage in the young,” says Henry Black, MD, president of the American Society of Hypertension. “We also urge physicians to identify children with hypertension as early as possible, especially obesity-associated hypertension, and to assess additional metabolic risk factors. We need to act now.”