Risk Factors Associated with the Development of Hypertension in Children

Lotas, Marilyn J.

The School of Nursing BSN Program at Case Western Reserve University has a 12 year long partnership with the Cleveland Metropolitan School District through which students provide selected health services to the school district children. One of those services is the completion of state mandated district wide health screening. Over the past four years over 8500 5th grade students have been screened for height, weight, BMI and blood pressure. Findings include: 43% of children are in the overweight or obese categories using the CDC standard and, over 200 children have been identified with blood pressures in the hypertensive range for height, gender and age over screenings on three separate dates.

Current Study: The purpose of the current study is to identify risk factors in the 5^th grade that are associated with the development of hypertension over the next 1-2 years. Four groups of 6th grade students are being followed. All children in three of the groups were identified with blood pressures in the normal range in the 5^th grade, but had some characteristic in the 5^th grade screening that could potentially be an early risk factor for later development of hypertension. The three groups are:

Group 1: Children with 5th grade BPs in the pre-hypertensive range (85th to 90th percentiles).

Group 2: Children with BPs in the hypertensive range on 2 of 3 5th grade screenings.

Group 3: Children with BMIs in the obese range but with normal 5th grade BPs.

A fourth group of children were randomly identified from the children with no identified risk factors for the development of hypertension.

Group 4: Children with BMIs and blood pressures in the normal range when screened in the 5^th grades.

Procedure: Approval for the study was obtained from the Case Western Reserve University IRB. Because these screenings are not part of the state mandated screening, parental consent was obtained for the children’s participation and child assent was obtained. In each of the four groups children are screened for height, weight and BP according to the same protocols used in the previous screening. In addition, a family history related to hypertension is obtained.

The final sample is anticipated to be approximately 50 children per group. It is anticipated that data analysis will be completed by May, 2015.