Overweight children face a far greater risk of high blood pressure than their leaner peers do, a study of Houston public schools shows. The findings, say researchers, "confirm an evolving epidemic" among U.S. children of weight-related ills once seen almost exclusively in adults. The study of 5,102 students ages 10 to 19 found that 4.5 percent had high blood pressure, and blood pressure rose in tandem with children's body mass index, or BMI. Among overweight children, 11 percent had high blood pressure, according to results published in the March issue of the journal Pediatrics.

High blood pressure is one of a number of cardiovascular conditions, including type 2 diabetes and high cholesterol, which are increasingly being seen in children as their rates of overweight and obesity climb. In the U.S., childhood obesity has doubled in the past 20 years, and more than 15 percent of kids between the ages of 6 and 19 are considered obese. In the past, the rate of high blood pressure among children has been
estimated at about one percent.

The new findings underscore the importance of preventing children from becoming overweight in the first place, according to study author Dr. Ronald J. Portman of the University of Texas Health Science Center in Houston. In an interview, he noted that the burden is on adults, as children are largely "powerless" over the problems of obesity and high blood pressure. What's needed, Portman said, are widespread efforts such as healthier,
junk-food-free school lunch programs and the revival of physical education in the schools.

"Society has to get together and say 'enough of this,"' he said. Among adults, high blood pressure is a major risk factor for heart attack and stroke over the long term. But the condition may have a more immediate impact as well.

There's some data suggesting high blood pressure can have subtle neurological effects, Portman noted. He said parents sometimes report improvements in their children's concentration and behavior once their blood pressure is under control.

Portman and his colleagues assessed blood pressure among students at eight public schools; high blood pressure had to be confirmed on three separate occasions for a child to be diagnosed with the condition.

Overall, 20 percent of the students had a BMI at or above the 95th percentile-the definition of "overweight" for children. The prevalence was highest among Hispanic students, 31 percent of whom were overweight. Twenty
percent of African-American kids were overweight, as were 15 percent of white and 11 percent of Asian children.

Hispanic children also more frequently had high blood pressure, a finding the researchers tied back to their disproportionately high BMIs.

Unless measures are taken to curb childhood obesity and its related health problems, the researchers conclude, the gains made in fighting cardiovascular disease over the last 50 years could eventually be lost.

SOURCE: Pediatrics, March 2004.