A cross-sectional study of 4074 children, ages 5--17 years, in Bogalusa, Louisiana indicated significant changes of serum lipids and lipoproteins occurring during puberty. These changes could be related to both age and maturation and likely reflect the influence of sex hormones on serum lipoprotein metabolism. Considerable differences were observed in the race/sex groups, with boys showing a more marked decrease of serum total cholesterol, reflecting decreases of beta- and alpha- lipoproteins. While the ratio of mean beta-lipoprotein cholesterol/mean alpha-lipoprotein cholesterol for the white girls and black children remained relatively constant over the age span, the ratio beginning around age 11 years rose dramatically in white boys, reflecting an inordinate decrease of alpha-lipoprotein and an earlier beginning rise of beta-lipoprotein. The observations have important implications for earlier coronary artery disease in white men.

SUMMARY Blood pressure, height, weight, maturation, triceps skinfold thickness, serum lipids, and hemoglobin were measured as risk factors for coronary artery disease in 3,524 children (93% of the eligible population) in Bogalusa, Louisiana. Nine blood pressures were taken on each child by trained observers with mercury sphygmomanometers (Baumanoneter) and Physomerics automatic recorders in a rigid randomized design in a relaxed atmosphere with other children present. The pressures observed were low compared to reported HYPERTENSION IN ITS EARLY STAGES is poorly understood. Perhaps this is due partly to our limited understanding of the disease and its subclinical manifestations, and to the scanty information concerning its timecourse changes. Furthermore, since there is a lack of satisfactory criteria for diagnosis, the true prevalence of hypertension in children remains to be established. For example, in contrast to the clinical and anatomic manifestations in adults, similar effects and early damage to tissue are undetectable in children. Simply, the early natural history of hypertension, the evolution from youth, needs to be investigated.The measurement of blood pressure in a young age segment of a total geographic American community offers the opportunity of delineating normative values specific for age, race, and sex and serves as a background for observing early hypertension in a free-living population. At the same time, such a study offers the opportunity of describing other characteristics that act as determinants of blood pressure. This study describes detailed blood pressure measurements in a biracial population of children in a southern, semi-rural community. Materials and Methods PopulationThe population consisted of all school children, ages 5 through 14, residing in Ward 4 of Washington Parish, Louisiana, including the town of Bogalusa. Ninety-seven percent of the black children and 91% of the white children participated in the study, a total of 3,524 children. Of the study population 37% were black and 63% were white. The results for 15-year-old children are included in the graphs of the present paper for illustrative purposes, but were not included in the calculations because of incomplete population coverage. InstrumentsDuring the school year 1973-1974, indirect blood pressures were obtained on the children by the mercury sphygmomanometer (Baumanometer) and by the Physiometrics automatic blood pressure recorder. The automatic instrument is an electronic infrasonic device that records on a paper disc rotated by an aneroid manometer in open communication with an oversized rubber cuff bladder entirely encircling the upper arm. Selection of the bladder sizes for the Baumanometer cuff was based on arm measurement criteria recommended by Karvonen et al.,1 Simpson et al.,2 and King,3 but with the restrictions that commonly available bladders were used and that shorter arms require a narrower cuff in order to leave room for the stethoscope at the elbow skin crease (see Appendix). Observer TrainingAll blo...

The relationship between body fat indexes, lipid and lipoprotein levels, and blood pressure was studied in 2230 children, each examined during 1973, 1976, and 1978. The children were grouped with the use of seven percentile (P) intervals of triceps skinfold thickness that were specific for race, sex, and age; cardiovascular risk factor variables were assessed over time. Of the 238 children initially in the lowest P group (<15P), 44% remained there, and 65% had skinfold thicknesses below 30P on the three occasions. Of the 352 children in the highest P group ('85P), who were considered to be very obese, 39% remained at this level while 69% remained at 70P or greater. Of the 366 considered to be obese (.70, <85P), 38% remained at or above 70P. At baseline, children in the seven groups differed in weight, ponderosity (wt/ht3), systolic and diastolic blood pressures, serum triglyceride levels, and pre-,/-and ,B-lipoprotein cholesterol levels. Pairwise comparison of data from children in each of the six other groups with those from children in the middle range (.40, <60P) showed that the obese and very obese children had significantly higher systolic blood pressures (p < .05), while only those in the highest P group had significantly greater diastolic blood pressures (p < .05). These differences increased and diverged over time. Those in the obese and very obese groups showed a striking drop over time in a-lipoprotein cholesterol levels and increases in pre-3-lipoprotein cholesterol levels and systolic blood pressure. Triglyceride levels decreased over time for the lowest and middle range groups but remained at higher levels in obese and very obese children. There was a strong tendency for tracking (remaining in the same P group over time) in lean, obese, and very obese children. Those who tracked showed definite differences in risk factor variables at the baseline level and over time when compared with the middle range group. Since consistent obesity in early life enhances cardiovascular risk, the measurement over time of skinfold thickness in children is a useful method to detect the potential for adult cardiovascular disease. Circulation 69, No. 5, 895-904, 1984. OBESITY is positively associated with cardiovascular risk factors such as hypertension, diabetes mellitus, and abnormal lipid and lipoprotein levels in adults. ' Although it has been related to other risk factor variables-9 in children, there is little information on effects of persistent obesity in early life. Because obesity can begin in childhood, it is important to determine the level at which it begins to influence cardiovascular risk. Individuals who have been obese from childhood tDeceased.Vol. 69, No. 5, May 1984 are of particular interest in the study of the early natural history of obesity and its relationship to the development of cardiovascular disease. Although no precise definition of obesity in a general population of children has been established, the tendency for a child to maintain over time the same relative rank in a dis...