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Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in Blood Pressure Among Children and Adolescents. JAMA. 2004;291(17):2107–2113. doi:https://doi.org/10.1001/jama.291.17.2107
Author Affiliations: Departments of Epidemiology (Drs Muntner, He, Wildman, and Whelton) and Medicine (Drs Muntner, He, and Whelton), School of Public Health and Tropical Medicine, School of Medicine, Tulane University, New Orleans, La; and Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Md (Dr Cutler).
Context The prevalence of overweight among children and adolescents increased
between 1988 and 2000. The change in blood pressure among children and adolescents
over that time and the role of overweight is unknown.
Objective To examine trends in systolic and diastolic blood pressure among children
and adolescents between 1988 and 2000.
Design, Setting, and Population Two serially conducted cross-sectional studies using nationally representative
samples of children and adolescents, aged 8 to 17 years, from the third National
Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994
(n = 3496) and NHANES 1999-2000 (n = 2086).
Main Outcome Measures Systolic and diastolic blood pressure levels.
Results In 1999-2000, the mean (SE) systolic blood pressure was 106.0 (0.3)
mm Hg and diastolic blood pressure was 61.7 (0.5) mm Hg. After adjustment
for age, mean systolic blood pressure was 1.6 mm Hg higher among non-Hispanic
black girls (P = .11) and 2.9 mm Hg higher among
non-Hispanic black boys (P<.001) compared with
non-Hispanic whites. Among Mexican Americans, girls' systolic blood pressure
was 1.0 mm Hg higher (P = .21) and boys' was 2.7
mm Hg higher (P<.001) compared with non-Hispanic
whites (P<.001). With further adjustment for body
mass index, these differences were attenuated. After age, race/ethnicity,
and sex standardization, systolic blood pressure was 1.4 (95% confidence interval
[CI], 0.6-2.2) mm Hg higher (P<.001) and diastolic
blood pressure was 3.3 (95% CI, 2.1-4.5) mm Hg higher in 1999-2000 (P<.001) compared with 1988-1994. With further adjustment
for differences in the body mass index distribution in 1988-1994 and 1999-2000,
the increase in systolic blood pressure was reduced by 29% and diastolic blood
pressure was reduced by 12%.
Conclusions Blood pressure has increased over the past decade among children and
adolescents. This increase is partially attributable to an increased prevalence
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