title: Elevated blood pressure, race/ethnicity, and C-reactive protein levels in children and adolescents.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Ave, Box 777, Rochester, NY 14642, USA. marc_lande@urmc.rochester.edu
authors.forename: Marc B
authors.initials: MB
authors.lastname: Lande
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Pearson
authors.forename: Roger P
authors.initials: RP
authors.lastname: Vermilion
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
authors.forename: Isabel D
authors.initials: ID
authors.lastname: Fernandez
mesh_terms: 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
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein