[Effect of diet and salt intake on the development of hypertension in children and adolescents]

Abstract

Arterial hypertension is a major risk factor for cardiovascular, cerebrovascular and renal diseases. A common opinion, even among physicians, is that arterial hypertension is rare in children and that it is mainly caused by renal disease. It only holds true for infants and small children. Essential hypertension is not so rare in school children and adolescents. The prevalence of essential hypertension in adolescents, particularly those near their twenties, is very close to that in adults. According to its prevalence, essential hypertension is the second most common chronic disease of childhood following asthma. Results of the EH-UH study on arterial hypertension in Croatia showed the prevalence of hypertension to be 37.5% in adults. It is logical to presume that hypertension does not begin at the age of 18, and that its onset should be sought in younger age. We witness a global epidemic of overweight/obesity. According to the WHO 2003 report, the prevalence of overweight/obesity in Croatia was 61.4% in the 18-100 age groups. There is a direct relationship between overweight/obesity and essential hypertension of childhood. Body mass index is greater in children with essential hypertension than in those with secondary hypertension. The risk of hypertension is three- to fivefold in children with overweight/obesity. According to a British study, the increase in salt intake by 1 g in children is associated with 0.4 mm Hg rise in systolic blood pressure and 0.6 mm Hg rise in pulse pressure. Prevention of cardiovascular disease begins in early childhood, through education of the population on healthy lifestyle which includes prevention of overweight/obesity, lower salt intake and regular physical activity.