Obesity and Overweight Interconnected Hypertension-A Common Condition not to be Overlooked Since Pediatric Ages

Abstract

Editorialhypertension leads to left ventricular hypertrophy [9]. Another deleterious fact is the association with heart failure, coronary disease and death before 55 years of age which has been linked to hypertension in pediatric ages [10]. The Iceland study [11] on target-organ damage later in life at a mean of 58 years showed a significant correlation between both coronary disease and adult hypertension when the adolescent blood pressure was >/= 95 th centiles. Karen McNiece [12] using the National High Blood Pressure norms, to be commented below, disclosed in adolescents not only the left ventricular hypertrophy but higher insulin levels with similar glucose levels compared to the controls [13]. This is an additional fact favoring insulin resistance with all the wellknown consequences After this analysis the appropriate clinical identification of pediatric elevation in blood pressure or better pre-hypertension, is compulsory and to rule out causes other than obesity. It is worth checking the existence or not of the metabolic syndrome that will put over the track of other comorbidities. Due to the normal variation of blood pressure as growth progresses the norms given in 2004 by the Working Group on High Blood Pressure in Children and Adolescents [13] (Table 1). Concerning the method for measuring blood pressure traditionally the auscultatory techniques (mercury column or aneroid devices) have been recommended and can still be considered as a reference, but the device variability and the subjectivity that they imply and the frequent persistence of Since 1960s when the Framingham Heart Study demonstrated the linkage between hypertension and bodyweight the interest in this subject has grown ever since. Presently it lies in its growing prevalence, tracking to adult ages and risk for suffering from cardiovascular diseases and mortality.The pathophysiology of this linkage is far beyond the present scope, but two facts are behind this: abdominal obesity and insulin resistance. Thus the consequences of both on sympathetic activity, leptin, renin-angiotensin system, sodium balance and epigenetic factors can have therapeutical implications [1].In adults, blood pressure is regularly assessed, particularly if suffering from overweight, due to the fact that 75 % of hypertension is related directly to obesity [2]. This is not the case in pediatric patients where primary hypertension is not very common and this together with other factors to be commented on later has led to a certain omission in regular pediatric checkups including obese children. However, according to the U.S. Preventive Service Task Force data, 11 % of obese children have high blood pressure [3] and the increasing prevalence parallels the degree of obesity [4]. Prevalence in Europe is greater with a range of 35 % to 39 % over 25000 overweight or obese children according to three different ethnicities [5]. In different countries with different income rates this association of hypertension and obesity has also been demonstrated although sample size is sma...

Blood Pressure in Schoolchildren and Adolescents and its Variation according to Nutritional Status Evaluation: An Early Preventive Key for Obesity Comorbidities

“…This is perhaps different from primary hypertension which is normally treated in the hypertension units. In previous publications [2,3] we analyzed the tracking of cardiovascular diseases (CVD) from pediatric ages, therefore, we now add two new epidemiological aspects. The first is related to the data that forecast that overweight children are at increased risk of becoming obese adults which may lead to shorter life expectancies in the current generation of children compared to their parents [4].…”