Hypertension in children and adolescents
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* Arianna Bocelli MD
* Piercarlo Ballo MD

We read with great interest the recent article by Karen Tu and colleagues concerning the prevalence of hypertension in adults aged 20 years and older.1 The authors' estimate for 1995–2005 in Ontario was considerably higher than the recent estimate by Kearney and colleagues of a 24% relative increase in the prevalence of hypertension from 2000 to 2025 in developed countries.2

Din-Dzietham and colleagues recently reported a 37% relative increase in the prevalence of hypertension in American children and adolescents between 1988 and 1999.3 The upward trend was particularly evident in boys; Tu and colleagues reported a similar finding in adults.1

Although the factors underlying the increase in the prevalence of hypertension are likely to be different in adults and children, obesity is an important determinant in both groups.4,5 In a recent analysis that combined data from the Third National Health and Nutrition Examination Survey (NHANES III, conducted from 1988 to 1994) and the NHANES 1999–2000 study, obesity accounted for nearly 30% of the increase in systolic blood pressure observed in children and adolescents over a 12-year period.5 Considering the potential impact that uncontrolled hypertension and high body mass index in children could have on the epidemiology of hypertension in the future, public health strategies to prevent hypertension and reduce overweight and obesity in children and adolescents are urgently required.

## Footnotes

*   **Competing interests:** None declared.

## REFERENCES

1.  1. Tu K, Chen Z, Lipscombe LL; Canadian Hypertension Education Program Outcomes Research Taskforce. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study. CMAJ 2008;178:1429-35.
    
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