Childhood Obesity, Arterial Stiffness, and Prevalence and Treatment of Hypertension

Abstract

Childhood obesity is associated with progressive vascular dysfunction as manifest by arterial stiffness and elevated blood pressure with associated subsequent morbidity and mortality because of early cardiovascular events including myocardial infarction and stroke in adulthood. Consequently, the recent dramatic increases in childhood obesity around the world present a hitherto unforeseen public health concern. While coordinated primary prevention efforts remain an ongoing important focus of action, identification and treatment of modifiable cardiovascular risk factors in pediatric patients is necessary given the existing burden of disease and future health consequences. Lifestyle interventions remain a cornerstone of our therapeutic approach, however, medical therapy is needed in some cases and should not be underutilized based on patient age. Herein, we discuss the relationship between childhood obesity and hypertension with a key emphasis on the evolution of adaptive and maladaptive vascular changes in the genesis of overt cardiovascular disease.

Physical activity modulates arterial stiffness in children with congenital heart disease: A CHAMPS cohort study

“…Low physical activity increases overweight and obesity risk, and these factors adversely contribute to arterial stiffness in children . Sakuragi et al found that BMI, waist circumference, and % body fat were all independently and positively associated with arterial stiffness in healthy children, and more so than exercise capacity.…”

“…We extend prior reports by demonstrating that physical activity volume may help modulate Low physical activity increases overweight and obesity risk, 19 and these factors adversely contribute to arterial stiffness in children. 20 Sakuragi et al 6 CHD may be more causally attributed to physical activity levels, rather than established anthropometric determinants of arterial stiffness.…”

Obesity and Arterial Stiffness in Children

“…37 Environmental and genetic factors unique to each child may affect arterial structure differently and could explain how the presence of hypertension in the absence of arterial stiffness might occur in children with obesity. 38,39 Another important consideration is that we are not able to exclude the possibility of publication bias, in which smaller studies with null findings may not have been published. Studies with significant or positive results may be published more often and faster than those with nonsignificant or negative results.…”

Prevalence of sustained hypertension and obesity among urban and rural adolescents: a school-based, cross-sectional study in North India

“…Previous studies have reported varying prevalence of hypertension in children ranging from <1% to 16.2% and the prevalence of obesity ranging from 12% to 19%, which may be due to varying age groups selected for the study and the different criteria adopted for defining hypertension and obesity 3–9. In addition, dietary and cultural factors and significant variation in the prevalence of point and sustained hypertension could influence the varying prevalence of high BP 10–14.…”