Clin Med Res. 2012 Aug;10(3):184.
CA4-02: When Additional Pounds Become a Health Threat: Childhood Obesity as a Risk for Hypertension?
Abstract
Background/Aims Extreme obesity is an increasing concern in pediatric care but its association with pre-hypertension and hypertension are not clear. The objective of the present study is to assess the prevalence of different stages of pre-hypertension and hypertension in the pediatric population, to investigate potential disparities, and to evaluate the ideal BMI-for-age thresholds for pre-hypertension and hypertension.
Methods In a cross-sectional study, blood pressure and measured height and weight were extracted from electronic medical records of 309,435 youth aged 6-19 years who were enrolled in an integrated, prepaid health plan in 2007-2009. Youths were defined as having low, moderate and high grade prehypertension or hypertension using a modified NHBPEP classification. BMI-for-age thresholds corresponding to increased risk for prehypertension and hypertension were evaluated using receiver operating-curves (ROC).
Results The prevalence of hypertension was 1.8% in boys and 1.5% in girls, respectively. In extremely obese, the prevalence of high grade pre-hypertension and hypertension was 30.3% and 8.5%, respectively, compared to 5.5% and 0.5% in normal weight. Hypertension was more frequent in Black, Hispanics, and Asian youth (p<0.001). The adjusted ORs of hypertension for normal weight, overweight, moderate obesity and extreme obesity were 1.00 (Reference), 2.63 (95% CI 2.36-2.94), 5.72 (95%CI 5.18-6.32), and 15.34 (95%CI 13.96-16.86), respectively. ROCs indicated a BMI-for-age threshold at the 90th percentile for high-grade pre-hypertension, and at the 95th percentile for hypertension.
Discussion Our findings suggest that extreme obesity in children substantially elevates risk for hypertension, which complicates pediatric care and may contribute to premature onset of cardiovascular disease in this pediatric population.
No comments:
Post a Comment