Hypertension Clinical Trial
To track blood pressure from childhood through adolescence.
BACKGROUND:
Children's Activity and Nutrition III was originally part of the Institute-initiated Studies
of Children's Activity and Nutrition (SCAN), first funded in 1985. Children's Activity and
Nutrition III was renewed in 1992 as a stand-alone project with a focus on assessment of the
development of hemodynamic mechanisms responsible for blood pressure (BP) control within the
context of ethnicity and family history of early myocardial infarction (MI), defined as
having a parent or grandparent with an MI at less than 55 years of age and a family history.
Blacks have a higher mortality rate through middle adulthood than whites from coronary heart
disease (CHD), the leading causes of death in the United States. Blacks have been found to
exhibit greater cardiovascular (CV) response to stress (i.e., reactivity), a potential risk
factor for CHD, as have individuals with a family history. . Although CHD has its
pathobiologic origins in childhood, little longitudinal reactivity research has been
conducted in youth, especially from childhood through late adolescence.
DESIGN NARRATIVE:
The study followed a multiethnic sample of 250 13 to 14 year olds for an additional 5 years
to determine: 1) whether blood pressure (BP) reactivity during childhood predicted changes
in resting BP, left ventricular mass and concentric remodeling, carotid artery wall
elasticity and endothelial dependent arterial dilation up to 11 years later after
controlling for other expected predictors (i.e., age, gender, ethnicity, resting BP,
adiposity, ambulatory BP); 2) the influence of ethnicity, family history and a select group
of moderator variables (i.e., environmental stress, anger and John Henryism coping styles,
aerobic fitness on youth's cardiovascular (CV) reactivity; and 3) the stability of CV
reactivity and a 24- hour ambulatory BP from childhood through late adolescence. The long-
term objectives were to provide a better understanding of the development of CV reactivity
in youth and its influence upon early pathobiologic markers of coronary heart disease prior
to overt manifestation of disease.
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