Adolescent Obesity, Change in Weight Status, and Hypertension

Abstract

We sought to determine whether change in weight status between adolescence and young adulthood was associated with the risk of developing hypertension among adolescents and whether gender and racial/ethnic group differences existed in the National Longitudinal Study of Adolescent Health. The sample was restricted to participants who self-identified as African-American, Hispanic or White Non-Hispanic (N=8543). Height and weight were measured in adolescence (mean 16yrs), and again in adulthood (mean 29yrs). We categorized the participants weight into four groups: stayed normal weight; gained weight (normal weight in adolescence and obese in adulthood); lost weight (overweight/obese in adolescence non-obese in adulthood); chronically overweight/obese. Hypertension was defined as measured systolic blood pressure of at least 140mmHg or diastolic blood pressure of at least 90mmHG measured in adulthood, or use of antihypertensive medications. A higher risk of hypertension was noted for all gender and racial/ethnic groups who became obese in adulthood. Furthermore, those who were chronically overweight/obese were at higher risk of hypertension for all groups with odds ratios ranging from 2.7 in Hispanic men to 6.5 in Hispanic women. Except for African-American men, those who lost weight during follow up had no significant increased risk compared to those who maintained normal weight. Overall, there was an increased risk of hypertension for those who gained weight in adulthood and among those who remained obese from adolescence to young adulthood. These data give further evidence for prevention strategies that begin earlier in life to reduce or delay the onset of chronic disease in young adults.

Racial Associations with Hemorrhagic Presentation in Cerebral Arteriovenous Malformations

“…Thomas et al (46) further hypothesized that increased sympathetic nervous system stimulation in the black population might be an underlying cause for development of hypertension. Similarly, an increased prevalence of hypertension was observed in the Hispanic population (3,10,39,44).…”

Change in Weight Status and Development of Hypertension

“…Even obese children and adolescents who lost weight by shifting to overweight or healthy weight had modest increases in SBP percentile; these patterns are consistent with others in the literature. 12,23 Of particular interest, a small percentage of obese and severely obese children and adolescents had a reduction in BMI to the healthy weight category. Because this study relied on a retrospective EHR review, we do not have data that might explain this change, other than there were no significant differences in the annual visit rate among the weight change categories.…”

“…[7][8][9] Previous studies have reported significant associated changes in BMI and BP from childhood to early adolescence 10,11 and in BMI and BP from adolescence to mean age 29 years. 12 Other studies have demonstrated a strong association between change in BMI z score and change in BP in adolescents. [13][14][15] In a recent metaanalysis of cross-sectional studies of BMI and cardiovascular disease risk factors in otherwise healthy children, overweight and obese children had systolic BPs 4.5 and 7.5 mm Hg higher compared with healthy weight children.…”

Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

“…34,36,37 Childhood adversity has been associated with obesity in children as young as 5 years of age, 45 and prospective research shows that childhood obesity and adolescent obesity have been associated with increased risk of cardiovascular risk factors and CVD among adults. [53][54][55] Data also suggest that whereas an unhealthy diet and sedentary lifestyle adversely affect physical and mental health, 56,57 a healthy diet and plentiful activity reduce inflammation, depression, and anxiety. 58,59 Thus, evidence increasingly suggests that behavioral risk factors, in part, mediate the childhood adversity-cardiometabolic disease relationship.…”