THECONTROL OF HYPERTENSION INAFRICAN-AMERICANCHILDREN: THE BOGALUSA HEART STUDY

Hypertension isthesecond mostcommonformof cardiovascular disease intheUnited States. Involving about onequarter oftheadult population, thedisease hasa greater prevalence andseverity intheblack population. Itisnowwellestablished thatprimary hypertension begins inearly childhood.' 2Although the mechanisms foritsinitiation arepoorly understood, epidemiologic studies ofpediatric populations whose bloodpressure levels havebeentracked showthat childhood blood pressure levels arepredictive oflevels inyoungadulthood. However, during childhood and adolescence, bloodpressure levels increase with growth, soitisnotentirely possible todefine whether thehigher bloodpressure levels atyoungagesare entirely physiological, abnormal, or portend later development ofhypertension inadulthood. Understanding thecharacteristics that place ayoungperson at increased riskforhypertensive disease iscritical for developing approaches tointervention andpreventing thenatural course ofessential hypertension. Considerable experience showsareduction ofmorbidity occurs withtreatment ofhypertension inadults, especially intervention inmildhypertension. Consequently, early treatment andprevention ofhypertension should haveconsiderable meritinpreventing target organdamageandultimately clinical disease. Studies ofthepediatric andyoungadult biracial (black/white) population inBogalusa, Louisiana, have provided dataonthenormative distribution ofblood pressure levels.3 TheBogalusa HeartStudyisa long-term epidemiologic study ofthenatural history of arteriosclerosis, coronary artery disease, andessential