Hypertension is the most prevalent disease in our population with stroke the second leading cause of deaths. Hypertension has a relatively low prevalence in children. But, there are a number of children being suffered from this problem in significance. There were 60-100 deaths annually from stroke before the age of 20 years in Taiwan. In the mass urine screening program conducted in 1992 through 2000 for elementary students, 8401 children with significant hypertension, 4229 with severe hypertension had been identified. Students with severe hypertension were more likely to have proteinuria and glucosuria. This proposed study will establish a cohort based on these hypertensive students (n=800) and students without hypertension (n=800), randomly selected from the 1995-2000 mass urine screening population. Both groups of students have been found to be glucosuria and/or proteinuria positive in a urine screening program. We would like to investigate the risk factors associated with childhood hypertension, family cluster and the treatment effectiveness and different levels of blood pressure (BP) control in showing the progression of cardiovascular disease (CVD) and renal diseases and other comobidity in hypertensive children. This study as a feasibility study has the following aims. 1. To create a protocol, an operation manual and data collection form. 2. To establish a cohort consists of hypertensive children and normotensive children (controls) identified from mass urine screening for elementary students. 3. To conduct a questionnaire investigation and health examination for factors that may associate with childhood hypertension by comparing hypertensive group and control group. 4. To assess patient compliance with their treatment protocol, including clinic visit schedules, medications and other procedures. 5. To observe any short-term adverse effects in the 3-year study period. 6. To obtain risks within patient variation in comobidity during the baseline and follow-up period. 7. To compare differences in blood/urine chemistry and lifestyle between children with and with no new comobidity. This study population based on a mass urine screening for glucosuria or/and proteinuria in children may have limitations generated from selection bias. The BP status may not represent general children. However, these children are at elevated risk of developing comobidity in cardiovascular and renal systems, they are a group children deserve immediate cares. This project will provide a prominent approach for identifying risks in the interaction of hypertension glucosuria and proteinuria, and identifying ways to prevent the development of comobidity. Based on the past experience in Chin-Shan Community Cardiovascular Cohort Study, the investigators would like to continue the follow-up task for the study subjects by the end of NHRI support. In doing so, all study subjects will continue to receive adequate care and consultation, the investigators will be able to precisely estimate the risk may occur in the treatment effectiveness.
