American Journal of Epidemiology Vol. 151, No. 10: 1007-1019
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Blood Pressure Differences between Blacks and Whites in Relation to Body Size among US Children and Adolescents
1channing Laboratory, Harvard University Boston, MA.
2Department of Public Health Sciences, Wake Forest University School of Medicine Winston-Salem, NC.
3Children's Hospital Medical Center and the University of Cincinnati Cincinnati, OH.
Reprint requests to Dr. Bernard Rosner, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115 (e-mail: stbar@gauss. med.harvard.edu)
No large national studies of ethnic differences in blood pressure among children accounting for body size differences have been published, to the author's knowledge. This report details the similarities and differences in systolic and diastolic blood pressures betweenn Black children and White children in the United States and examines the effects of age, sex, and body size on ethnic differences in blood pressure levels. Standardized measurements of seated systolic and diastolic pressures from eight large epidemiologic studies published between 1978 and 1991 that included measurements of 47, 196 children on 68, 556 occasions for systolic pressure and for 38, 184 children on 52, 053 occasions for diastolic pressure were used; 51 percent (24, 048 children) were boys and 37 percent (17, 466 children) were Black. Overall, there appear to be few substantive ethnic differences in either systolic or diastolic pressure during childhood and adolescence. The differences that were observed were small, inconsistent, and often expalained by differences in body size. There was an ethnic group-body mass index (BMI) interaction that resulted in these findings that at lower levels of BMI Blacks have higher blood pressure and more hypertension than do Whites, but that at the highest levels of BMI, Whites have more hypertension (systolic or diastolic pressure) than do Blacks. Am J Epidemiol 2000: 151: 1007-19.
blood pressure; body mass index; ethnic groups; hypertension
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