Weight, high BP risk correlated in children, adolescents

BARCELONA, Spain — Prevalence of elevated BP increased as body weight rose in children and adolescents, according to findings from the PEP Family Heart Study presented at ESC Congress 2014.

Researchers examined the association between elevated BP and fat patterning in children and adolescents, estimating BMI, waist circumference, waist-to-height ratio, percentage of body fat and the sum of subscapular and triceps skinfold thickness in 14,213 children and 7,838 adolescents aged 3 to 18 years in an observational study from 1993 to 2007.

Peter Schwandt, MD, PhD, and colleagues found that the prevalence in prehypertension for boys was 13.2% for normal weight, 18.3% for overweight and 21.9% for obese, whereas for girls it was 12.9% for normal weight, 18.7% for overweight and 24.9% for obese. They also found that the prevalence of hypertension for boys was 5.7% for normal weight, 10.4% for overweight and 18.6% for obese, whereas for girls it was 5% for normal weight, 9.1% for overweight and 24.4% for obese.

Compared with those of normal weight of the same sex, the risk for being prehypertensive was higher in overweight boys (OR=1.6), overweight girls (OR=1.8), obese boys (OR=2.4) and obese girls (OR=3.3), Schwandt, of the Arteriosclerosis Prevention Institute in Munich, Germany, and colleagues found.

The highest risks for developing hypertension were for obese (defined as BMI >95th percentile for age and sex) boys (OR=4.3), obese girls (OR=5.9), sum of subscapular and triceps skinfold thickness >35 cm in boys (OR=4.6) and girls (OR=5.8), percentage of body fat >95th percentile for age and sex for boys (OR=3.4) and girls (OR=5.6), waist-to-height ratio >0.5 for boys (OR=3.8) and girls (OR=3.9) and waist circumference >90th percentile for age and sex in boys (OR=3.1) and girls (OR=3.5), according to the researchers.

Those who were obese and had a high percentage of body fat were at particularly high risk for hypertension (OR for boys=4.5; 95% CI, 3.7-5.5; OR for girls=6.3; 95% CI, 5.1-7.7), Schwandt said at a press conference.

“Combined waist circumference plus waist-to-height ratio is a good measure for early hypertension,” he said.

It is not possible to treat to a target BP in children and adolescents because they are constantly growing, “so we only have sliding and risking risk” for the basis of treatment, Schwandt said. “We have to decide when to do what. The easiest way is to try to change lifestyle … as early as possible. What can we do if we have high BP in children? Decrease body weight and treat obesity.” — by Erik Swain

For more information:

Schwandt P. Abstract P2992. Presented at: the European Society of Cardiology Congress; Aug. 30-Sept. 3, 2014; Barcelona, Spain.

Disclosure: Schwandt reports no relevant financial disclosures.