Racial (black-white) contrasts of risk for hypertensive disease in youth have implications for preventive care: the Bogalusa Heart Study.

Cardiovascular (CV) diseases remain the major cause of illness and death in the United States. Adverse CV outcomes are influenced by race/ ethnicity and sex. Race and sex contrasts of CV risk factors become evident early in life and have implications for prevention and medical care. Changes in the CV system in hypertensive disease are mediated by interplay among body fatness, insulin sensitivity, and other factors such as renin-angiotensin system and electrolyte homeostasis. Observations from the Bogalusa Heart Study found higher blood pressure levels in Black children even without obesity, renin as a component of the metabolic/insulin resistance syndrome mainly in Whites, and Black-White differences in electrolyte handling, eg, lower urinary excretion of potassium in Blacks. Understanding divergences in hemodynamic and metabolic parameters for developing hypertensive disease can help improve approaches to beginning prevention at an early age. The use of low doses of antihypertensive medications along with prudent diet and physical activity may be considered for children with elevated blood pressure.