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Blood pressure in obese and overweight children and adolescents.

BACKGROUND
The prevalence of obesity in children and adolescents has increased dramatically in the last few decades. Primary hypertension, a known secondary complication among obese adults, has been considered rare in children.


OBJECTIVES
To investigate the prevalence of hypertension and its relation to body mass index (BMI) in obese children aged 9-17 years in Israel.


METHODS
Weight, height, BMI, and systolic and diastolic blood pressure (BP) (twice) were measured in children attending general and pediatric endocrine clinics. Obesity was defined as BMI > or = 95th percentile and overweight as BMI > or = 85th percentile. Pre-hypertension and hypertension were defined as systolic and/or diastolic BP > or = 90th percentile for age, gender and height and BP > or = 95th percentile respectively. In children with pre-hypertension or hypertension, repeated measurements were performed.


RESULTS
We evaluated 264 children of whom 152 had BMI > or = 85th percentile (study group). Their mean age was 12.5 years. The prevalence of elevated BP (both pre-hypertension and hypertension) in the study group was 44.1% and 31% at the first and second measurements respectively, compared to 11.6% and 1.9% in the normal-weight group. Hypertension was documented in 17.2% of the study group at the second measurement.


CONCLUSIONS
Elevated BP was diagnosed in 31% of overweight and obese children and adolescents. Increased awareness and early diagnosis and treatment are essential.