HAVE you ever given thought to high blood pressure (hypertension) occurring in children? Did you think high blood pressure only affected adults?

Well, there are certain endocrine (hormonal) and kidney diseases that cause sustained elevated blood pressure in children, leading sometimes to very harmful short- and long-term consequences.

In addition to the foregoing causes, researchers have now discovered that young children and teenagers who lack good access to nutritional foods are also more likely to have high blood pressure than other children who have a secure access to food.

A relatively new term being used to describe a long-standing problem in numerous lower-and middle-income countries, food insecurity is the state of being without a reliable access to a sufficient quantity of affordable and nutritious food. More than 800 million people live every day with hunger or food insecurity. The latter has now been found to be an important contributor to high blood pressure during childhood.

Research shows the link

Data obtained from the National Health and Nutrition Examination Survey (NHANES) in the USA, was the first to link food insecurity with high blood pressure in children and adolescents.

The researchers from the Hypertension Clinic at the Brenner Children’s Hospital and the paediatric nephrology department of Wake Forest School of Medicine in Winston-Salem, North Carolina, USA, recommended as a result of the research that primary care doctors screen for food insecurity in both children and adults as a risk factor for cardiovascular disease.

The study involved data from 7,215 children in the age range eight to 17 years. Food insecurity was assessed using the US Department of Agriculture (USDA) food security survey module. Blood pressure measurements were done three times and averaged.

More than one-fifth of the children (1,460 out of 7,125, that is 20.5 per cent) were food insecure, and about 12.4 per cent (883 of 7,125) had high blood pressure. Using statistical analysis, they found that hypertension was significantly more common in food insecure than in food secure children.

While they currently do not know the exact reasons why food insecurity is associated with high blood pressure in children or in adults, the researchers thought there likely is a multifactorial social and biological risk factor that includes contributions from poor nutrition (such as higher salt intake) and long-term (chronic) stress from not having reliable or consistent access to healthy food.

Solutions

Programmes have now been developed at the researchers’ home institutions to intervene in those children with food insecurity in order to provide nutritional and social support, including meeting with nutritionists and social workers, helping with applications to food assistance programs, and providing access to food pantries.

However, the researchers stated that it was vital that leaders and decision-makers at the policy level understand the importance of food insecurity to overall health, as well as recognising that high blood pressure and cardiovascular disease originate during childhood, and are significant health care burdens in childhood. The research study supported the idea of increasing access to nutritionally adequate food and educating health care providers and families regarding the importance of adequate nutrition in order to prevent or minimise the impact of disease.

A large public health issue

While the finding that links food insecurity with high blood pressure in children is alarming, it is not too surprising when you think that food insecurity is not only about persons not having enough food, but also about them not having enough of the right kinds of food, since the latter would help to minimise the risk of high blood pressure.

In the USA, food insecurity affects an estimated 40 million Americans, including 6 million children and adolescents. The statistics are likely to be much worse for many lower-and middle-income countries. This makes it a huge public health issue that is not being frontally addressed.

So health care providers should always be looking beyond their normal clinical routine. Yes, they should screen for blood pressure, but they should also screen for nutrition in an attempt to mitigate risks for high blood pressure.

Addressing social needs

Many social needs exist within families, but food insecurity is probably one issue that nearly all influential persons within a society can help to address. Food, shelter and clothing are the most basic needs of every human being, but the reality is that solving the issue of food insecurity is less difficult than addressing a lack of adequate housing for the population.

As a nation, let us work to improve health, welfare and longevity through concerted efforts to reduce food insecurity among our children and other members of the family.

Dr Derrick Aarons MD, PhD, is a Jamaican family physician and consultant bioethicist; a specialist in ethical issues in health care, research, and the life sciences; the health registrar and head of the health secretariat for the Turks & Caicos Islands, and a member of UNESCO’s International Bioethics Committee (IBC).