Elevated blood pressure, race/ethnicity, and C-reactive protein levels in children and adolescents.
OBJECTIVE
Adult hypertension is independently associated with elevated C-reactive protein levels, after controlling for obesity and other cardiovascular risk factors. The objective of this study was to determine, with a nationally representative sample of children, whether the relationship between elevated blood pressure and C-reactive protein levels may be evident before adulthood.


METHODS
Cross-sectional data for children 8 to 17 years of age who participated in the National Health and Nutrition Examination Survey between 1999 and 2004 were analyzed. Bivariate analyses compared children with C-reactive protein levels of >3 mg/L versus <or=3 mg/L with respect to blood pressure and other cardiovascular risk factors. Multivariate linear regression was used to evaluate the relationship between elevated blood pressure and C-reactive protein levels.


RESULTS
Among 6112 children, 3% had systolic blood pressure of >or=95th percentile and 1.3% had diastolic blood pressure of >or=95th percentile. Children with C-reactive protein levels of >3 mg/L had higher systolic blood pressure, compared with children with C-reactive protein levels of <or=3 mg/L (109 vs 105 mm Hg). Obesity, high-density lipoprotein cholesterol levels of <40 mg/dL, and Hispanic ethnicity were independent predictors of elevated C-reactive protein levels. Diastolic blood pressure did not differ between groups. Linear regression analyses showed that systolic blood pressure of >or=95th percentile was independently associated with C-reactive protein levels in boys but not girls. Subset analyses according to race/ethnicity demonstrated that the independent association of elevated systolic blood pressure with C-reactive protein levels was largely limited to black boys.


CONCLUSIONS
These data indicate that there is interplay between race/ethnicity, elevated systolic blood pressure, obesity, and inflammation in children, a finding that has potential implications for disparities in cardiovascular disease later in life.
Lande
Marc B
MB
Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Ave, Box 777, Rochester, NY 14642, USA. marc_lande@urmc.rochester.edu
Pearson
Thomas A
TA
Vermilion
Roger P
RP
Auinger
Peggy
P
Fernandez
Isabel D
ID
D000293:Adolescent; D017677:Age Distribution; D015415:Biomarkers / Q000032:analysis; D001795:Blood Pressure Determination; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D002097:C-Reactive Protein