HYPERTENSION AND ATHEROSCLEROSIS IN CHILDREN

This article reviews important advances in the understanding and treat ment of hypercholesterolemia and persistently high blood pressure in c hildren..Two plant sterols, sitosterol and sitostanol, have been teste d in prepubertal and adolescent children with hypercholesterolemia and appear promising. The advantages and disadvantages of family history in screening algorithms for atherosclerotic disease are discussed. Add itionally, the apolipoproteins are being used more frequently to scree n for cardiovascular risk. A rare genetic disease, familial defective apolipoprotein B-100, causes hypercholesterolemia. The distinction bet ween this disease and familial hypercholesterolemia has therapeutic im plications. Two studies show that in utero exposures influence the fut ure development of hypertension. Intrauterine cocaine exposure was ass ociated with persistently elevated blood pressure during later childho od. The mechanism may involve the sympathetic nervous system. Retarded fetal growth appears to be a risk factor for the presence of hyperten sion during adult years in men.