Va'Sean Duvall is a skinny 17-year-old who stays busy with an after-school job, choir rehearsals and school drama productions. On the surface, he doesn't fit the mold of someone - older, obese and inactive - who would be at risk for high blood pressure.
Yet he's among as many as 4 million children in the United States estimated to have hypertension, a figure that has grown fivefold in the past generation, according to Johns Hopkins researchers. It's a condition that doctors often fail to diagnose and one that leaves children - particularly African-Americans - at risk for serious heart problems, says a recent Hopkins study.
Doctors have known that a rising number of children are at risk for high blood pressure, and they think the nation's surging child obesity rate is a prime cause. But now, researchers are trying to learn more about the specific heart problems triggered by high blood pressure and hope to sound the alarm on the importance of catching hypertension early.
"We need to do a better job at increasing the public awareness, and we need to look at what are the barriers of physicians in recognizing high blood pressure in a clinical setting," said Dr. Tammy Brady, a pediatric nephrologist at the Johns Hopkins Children's Center and one of the study's authors.
Brady and other researchers found that black children with high blood pressure are more likely than other children to develop a thickening of the left chamber of the heart. Known as left ventricular hypertrophy, or LVH, the condition can lead to heart failure, rhythm abnormalities and death.
Of 139 hypertension patients ages 3 to 21 in the Hopkins study, 60 percent of the black subjects developed LVH, compared with 37 percent for those of other races.
"It's concerning that the prevalence is higher in the African-American population," said Dr. Cozumel Pruette, a kidney specialist at Hopkins Children's Center and the study's lead author. "Practitioners need to realize that and need to follow those children closely."
Researchers don't know why the disparity exists. Black children with LVH also tended to have higher cholesterol levels and a higher body mass index, putting them at greater cardiovascular risk, Pruette said. Since the study was among the first to look at racial differences and was done with a small sample, she said, more research is needed to understand why black children are especially vulnerable.
