Childhood obesity, arterial stiffness, and prevalence and treatment of hypertension.

OPINION STATEMENT: Childhood obesity is associated with progressive vascular dysfunction as manifest by arterial stiffness and elevated blood pressure with associated subsequent morbidity and mortality because of early cardiovascular events including myocardial infarction and stroke in adulthood. Consequently, the recent dramatic increases in childhood obesity around the world present a hitherto unforeseen public health concern. While coordinated primary prevention efforts remain an ongoing important focus of action, identification and treatment of modifiable cardiovascular risk factors in pediatric patients is necessary given the existing burden of disease and future health consequences. Lifestyle interventions remain a cornerstone of our therapeutic approach, however, medical therapy is needed in some cases and should not be underutilized based on patient age. Herein, we discuss the relationship between childhood obesity and hypertension with a key emphasis on the evolution of adaptive and maladaptive vascular changes in the genesis of overt cardiovascular disease.