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Serum lipids (total cholesterol and triglycerides) and lipoprotein cholesterol fractions (low density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, and high density lipoprotein (HDL) cholesterol) have been measured approximately every 3 years on children and young adults since 1973-1974 in Bogalusa, Louisiana, a community of approximately 22,000 individuals, one-third of whom are black and two-thirds of whom are white. A total of 1,586 children were examined both at baseline (1973-1974) and at the most recent survey (1984-1986), providing 12 years of follow-up. The decreases in levels noted during puberty for total cholesterol and LDL cholesterol, primarily for boys, were followed by a rise until age 26 years. HDL cholesterol levels, particularly for white boys, continued to drop after age 14 years, yielding increasingly high LDL cholesterol/HDL cholesterol ratios. Tracking, as measured by both correlation coefficients and persistence at extreme quartiles, was evident for all of the lipids and lipoproteins. The 12-year correlation coefficients were greatest for LDL cholesterol and no trend in the magnitude of the correlation coefficients with age was noted. Tracking for HDL cholesterol was better after age 9 years, particularly for white males. Approximately 50% of those children who had total cholesterol levels or LDL cholesterol levels above the 75th percentile at baseline remained elevated 12 years later. For HDL cholesterol, a trend with age was noted for white boys: 42% of those aged 9-14 years in the lower most quartile persisted in this rank 12 years later. The best predictor of follow-up lipid or lipoprotein level was baseline level. The next best predictor was increase in weight as defined by weight/height, an index of obesity. That serum lipid and lipoprotein levels continue to track from childhood into young adulthood points to the necessity of measurement early in life and, where indicated, the introduction of preventive and interventional programs aimed at developing healthy lifestyles.

Eighty per cent of all identified children 2 1/2-5 1/2 years old in a total geographic community in Bogalusa, Louisiana, were examined for cardiovascular disease risk factor variables, including blood pressure (BP), anthropometric measurements, and blood lipids. Blood pressure was measured by three instrument types, each with three readings, according to a rigid, randomized design. Results from the three instruments were compared, and potential biases for each instrument are listed. All observations on the children were analyzed by multiple regression with BP as the dependent variable. After controlling for the mood of the child, the authors found that some index of body size was positively related to BP, whereas age, race, and serum lipids were not consistently related. The regressions of blood pressure on height as well as on log weight fit straight lines. These results conform with the findings for the 5- to 14-year-olds in this community. The basal or fundamental reference blood pressure is likely to rise gradually from birth to the age of incipient adult stature, and to be linearly related to height and to log weight. Changes observed over time are needed to relate BP levels in childhood to the early natural history of essential hypertension.

Since a positive association between blood pressure and plasma glucose level in child populations has been observed previously, we studied this relationship in a stratified random sample of children ages 7-15 years drawn from a total geographic population. We stratified this population (N = 3524) by diastolic blood pressure and weighted the extreme strata. The sample of children (N = 272) was free of secondary hypertensives and was tested by a restricted glucose tolerance test. As a parameter of cellular glucose kinetics, a "peripheral insulin resistance" was defined as one-hour glucose (mg/dl) X one-hour insulin (microU/ml). For white boys, this product showed an increase from 2745 in the low blood pressure strata to 6615 in the high blood pressure strata. To assess the relationship between blood pressure measured during the reexamination and fasting plasma glucose level, we classified the children according to their peripheral insulin resistance in a low, medium, and high group. After controlling for body weight, only white children in the high blood pressure strata with high insulin resistance had a positive association between fasting plasma glucose and systolic blood pressure. The relationship may be initiated by inappropriate intravascular water retention influencing the blood pressure in children with high peripheral insulin resistance and susceptible to hypertension.

This paper reports on a study of all school-age children from Bogalusa, Louisiana, examined during the 1973-1974 and 1976-1977 school years by personnel of the Specialized Center of Research-Arteriosclerosis. For these children, the authors estimated the proportion of total variability in risk factors for atherosclerosis resulting from the influences of heredity (h2) and of common environment (c2). The authors' method of classifying half siblings underestimated h2 but overestimated c2. The results showed statistically significant values of h2 for height (0.91), weight (0.90), systolic blood pressure (.137), triglycerides (0.88), beta-lipoprotein (1.16), and alpha-lipoprotein (0.63). In addition, c2 was statistically significant for height (0.20), weight (0.32), triceps skinfold (0.19), systolic blood pressure (0.30), beta-lipoprotein (0.21), and alpha-lipoprotein (0.13). Because of the definition of c2, all traits for which it is significant must increase in value for some Bogalusa environments, and decrease for others. Therefore, for such traits, future analyses may identify favorable common environments that intervention studies can use to decrease the risk of atherosclerosis in Bogalusa. The values found for h2 and c2 in Bogalusa were compared and contrasted with values found for other communities.