Pathogenesis of hypertension in black and white children

Studies of cardiovascular risk factors in children conducted in the Bogalusa Heart Study provide a better understanding of the early natural history of essential hypertension. Contrasts in the biracial community of Bogalusa furnish some clues as to why essential hypertension is more prevalent in blacks. Black children tend to have higher blood pressure levels than whites. Autopsy studies and echocardiographic examinations have provided evidence of early cardiac enlargement in children and young adults with blood pressure levels in the 90th percentile. This suggests that the anatomic changes related to high blood pressure levels occur early in life. Blacks have lower plasma renin and serum dopamine β‐hydroxylase levels than whites. In general, obesity is not as closely correlated with higher blood pressure levels in black children as in white children. Prevention of hypertension should begin in early life. A major approach may be to educate children about cardiovascular risk factors and to encourage them to adopt healthy lifestyles while still young.