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Blood pressure risk cited in youths

Study says threat often undiagnosed

CHICAGO -- More than 1 million US youngsters have undiagnosed high blood pressure, leaving them at risk of eventually developing organ damage, a study suggests.

Calculating elevated blood pressure in children is trickier than in adults, and many doctors may not bother evaluating children's numbers because they assume hypertension is an adult problem. But the study highlights that many children are affected, too, said lead author Dr. David Kaelber of Case Western Reserve University in Cleveland and Harvard Medical School. Researchers have estimated that about 2 million US youngsters have high blood pressure; the study suggests that three-quarters of them do not know they have it.

The numbers are driven at least in part by rising rates of obesity, which is strongly linked with high blood pressure.

Untreated high blood pressure can cause health problems in adults, including heart disease, strokes, artery damage, and kidney disease, problems that usually take years to develop. Its effects in children are less certain, although there is some evidence that it might contribute to early artery and heart damage, according to the American Academy of Pediatrics.

"We can't wait until they've had a stroke to figure this is a problem," said Dr. Reginald Washington, a Denver pediatrician and member of the academy obesity task force. He was not involved in the research.

Washington said diagnosing high blood pressure in children is just the first step.

"Then you've got to sit down and go over family history, talk about diet, exercise," and other potential treatments, including medicine, although weight loss and exercise alone often succeed in children, he said. "To ignore it doesn't make any sense to me."

The study appears in today's Journal of the American Medical Association.

The researchers analyzed medical records for 14,187 healthy children ages 3 to 18 who had at least three doctor checkups in northeastern Ohio between June 1999 and September 2006. Kaelber said similar results probably would be found in other US children.