The number of children and adolescents being prescribed medication for high blood pressure and type 2 diabetes has gone up significantly since 2004, a recent study shows, revealing a trend some experts believe points to the childhood obesity epidemic.

The study, published in the April issue of the Chicago-based Archives of Pediatrics and Adolescent Medicine, showed that the prevalence of prescriptions for high blood pressure, elevated cholesterol or diabetes increased by about 15 percent from November 2004 to June 2007.

Joshua N. Liberman, lead researcher for the CVS Caremark study, said the significant increases in prescriptions were not particularly surprising, given the childhood obesity epidemic and increased consciousness of it among doctors and caregivers.

"We believe the findings were consistent with what a lot of the research around hypertension, diabetes and related cardiac conditions in pediatric populations would suggest," he said. "We suspect it is a combined increase in cardiovascular risk factors and physician awareness of the problems and their screening, diagnostics and treatment practices."

Researchers from the Hunt Valley, Md. pharmacy benefits manager used a database to assess the monthly prescription of drugs used to treat the conditions. The population size varied from 5.3 million to 6 million individuals between 6 and 18 years of age.

Dr. Reginald Washington, a Denver-based obesity expert consultant for the American Academy of Pediatrics in Elk Grove Village, also said  the increase per 1,000 youths from 3.3 to 3.8 was not surprising.

"When children become obese, they suffer various complications," he said. "We have seen over the last 10 years or so a dramatic increase of obesity and overweight in children. This is a natural result of what we’re seeing."

Chief among the complications, according to Washington, is type 2 diabetes. He noted that high blood pressure and high cholesterol are common among overweight and obese children, but said medication is not the primary way to address any of the issues.

"In my experience as a pediatrician, most children can avoid the use of medication if they lose weight," Washington said. "The recommendation is to try to change lifestyle first. If that doesn’t work, medication is indicated."

Dr. Cathy Joyce, a pediatrician at Rush University Medical Center in Chicago, pointed out that if certain levels are extremely high, pharmaceuticals might be necessary to prevent extreme complications. Washington said that prescriptions are often used as a last resort if health improvements don’t occur within three to six months.

But he doesn’t think this study indicates overuse of the drugs, rather an increased demand for them.

"Rather than looking at the end result, I’d rather people say, ‘Why is that?’" Washington said. "We pick on one little thing and ignore how complex this issue is."

Joyce said that one of the challenges of working with children is partnering with their parents, who sometimes don’t understand the ramifications of the illnesses.

"I have some parents calling in asking, ‘Is there a pill I can take?’" Joyce said. "But it takes time and work."

The study also showed a 23 percent reduction in cholesterol-controlling drugs, including statins such as Lipitor and Crestor. Washington said that trend aligns with an academy recommendation against statin therapy for children, a recommendation that changed in 2008.

"I suspect in the next several years, we will see an increase in cholesterol medications [based on the new recommendation]," Washington said, although he pointed out that diet and exercise are still the primary treatment for high cholesterol in kids.

The study showed the most significant increase in prescriptions among the youngest of the populations, children between 6 and 11. Although Liberman said the prevalence of the medications in that age group is still low, it experienced the highest spike: nearly 19 percent for girls and about 17 percent for boys.

According to Washington, this increase is consistent with the fact that children under the age of six don’t often display side effects from obesity. In his experience, the complications begin to manifest between the ages of 6 and 10, with children over the age of 10 suffering the most obvious side effects.

"I’m seeing more physicians trying to intervene earlier," Joyce said. "They want to get to them early and try to prevent [side effects]. The earlier you intervene, the easier you can change someone’s lifestyle."

According to Liberman, addressing side effects of chronic illnesses such as obesity often falls to primary care physicians. And he hopes that the results of the study will contribute to the dialogue among clinicians and the populations they serve.

"It’s not specialists who are handling this; it’s the primary care providers," Liberman said. "They’re on the front lines."