The relationship of body mass index and blood pressure in primary care pediatric patients

Falkner, Bonita; Gidding, Samuel S.; Ramírez-Garnica, Gabriela; Wiltrout, Stacey Armatti; West, David W.; Rappaport, Elizabeth B.

doi:10.1016/j.jpeds.2005.10.030

Cited by 227 publications

(163 citation statements)

References 11 publications

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“…34 In a recent large study of paediatric patients, an association was found for systolic and diastolic BP in all age groups, including in children aged less than 6 years. 35 Other studies indicate that BMI was associated more strongly with systolic BP than diastolic BP. 12,13 In a representative sample of youths aged 9, 13 and 16 years of Québec (Canada) in which the prevalence of excess body weight was 22-25% (based on BMI X85th percentile, the US reference tables), the prevalence of 'high normal' or 'elevated' systolic BP (i.e.…”

Section: Discussionmentioning

confidence: 97%

“…40,41 Most other epidemiological studies of children BP also relied on readings taken on a single occasion. 13,15,33,35 Second, because of the scarcity of data linking BP in children and subsequent disease outcomes, the definition of 'elevated BP' largely relies on arbitrary normative values. The most frequently used reference values are derived from American children examined in the 1980s, that is before the epidemic of overweight.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country

et al. 2006

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We assessed the prevalence of elevated blood pressure (BP) and the association with excess body weight among a large sample of children in the Seychelles, a middle-income rapidly developing country in the African region. Weight, height and BP were measured in all children of four school grades in the Seychelles (Indian Ocean). Excess weight categories ('overweight' and 'obesity') were defined according to the criteria of the International Obesity Task Force. Two BP readings were obtained on one occasion. 'Elevated BP' was defined based on US reference tables. Data were available in 15 612 (86%) of 18 119 eligible children aged 5-16 years in [2002][2003][2004]. In all, 13.0% of Boys and 18.8% of girls were overweight or obese. The prevalence of elevated BP was 9.1% in boys and 10.1% in girls. Both systolic and diastolic BP were strongly associated with body mass index (BMI) in boys and in girls. In children with 'normal weight', 'overweight (and not obesity)' and 'obesity', respectively, proportions with elevated BP were 7.5, 16.9 and 25.2% in boys, and 7.5, 16.1 and 33.2% in girls. Overweight (including obesity) could account for 18% of cases of elevated BP in boys and 26% in girls. Further studies should examine the impact of the relationship between BMI and elevated BP on the burden of hypertension in the context of the epidemic of paediatric obesity.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country

et al. 2006

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“…27 Thus, BMI should be taken as a potential confounder in the relationship between SUA and BP. The reduction of SUA we observed in our patients in association to weight loss was somewhat predictable given the type of intervention used in the present study.…”

Section: Discussionmentioning

confidence: 99%

Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

et al. 2016

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P rimary hypertension is a growing concern in children and adolescents in western countries largely because of its association with the ongoing obesity epidemic. Elevated serum uric acid (SUA) levels are frequently found in children with hypertension and obesity.1 Although primary hypertension in children was initially thought to reflect the underlying presence of subtle renal damage and insulin resistance, recent epidemiological and experimental data support the hypothesis that SUA may play an independent pathogenetic role in the early stages of vascular damage and the subsequent development of hypertension.2 Moreover, hyperuricemia has been associated with increased risk of hypertension development in adults in a large number of studies published to date. [3][4][5] Among participants in the Bogalusa Heart Study, SUA levels measured during childhood and greater changes in SUA from youth to adulthood were significant predictors of adult blood pressure (BP) values.6 Accordingly, recent meta-analyses indicate that high SUA levels entail an increased risk of hypertension incidence 7 with a consistent dose-response relationship, which supports causal disease-exposure association. have consistently been demonstrated to induce significant increases in SUA levels. In this context, SUA is emerging as a potentially modifiable risk factor for the prevention and treatment of hypertension. In fact, a reduction in SUA levels has been shown to prevent the development of hypertension in animal models, 10,11 and preliminary clinical trials indicate a BP-lowering effect of SUA reduction by either xanthine See Editorial Commentary, pp 845-847Abstract-Primary hypertension is a growing concern in children because of the obesity epidemic largely attributable to western lifestyles. Serum uric acid is known to be influenced by dietary habits, correlates with obesity, and could represent a risk factor for hypertension. Preliminary studies in children highlighted uric acid as a potentially modifiable risk factor for the prevention and treatment of hypertension. The effect of lifestyle changes (increase of physical activity and dietary modifications) on blood pressure values, weight status, and serum uric acid levels in a cohort of 248 children referred for cardiovascular risk assessment were evaluated over a mean 1.5-year follow-up. At baseline, 48% of children were obese and 50% showed blood pressure values >90th percentile. At follow-up, a significant improvement in weight class (24% obese; P<0.0001) and blood pressure category (22% >90th percentile; P<0.0001) was found. Systolic blood pressure z-score (P<0.0001), uric acid value (P=0.0056), and puberty at baseline (P=0.0048) were independently associated with higher systolic blood pressure z-score at follow-up, whereas a negative association was observed with body mass index z-score decrease during follow-up (P=0.0033). The risk of hypertension at followup was associated with body mass index (P=0.0025) and systolic blood pressure (P<0.0001) z-score at baseline and inversely related t...

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“…However, the BMI of children and adolescents is strongly associated with blood pressure [28], as well as adiposity (measured by dual-energy X-ray absorptiometry) and metabolic risk factors, including glucose, insulin, and lipids [29]. Furthermore, childhood BMI is related to BMI, adiposity, insulin, lipids, and systolic blood pressure in adulthood [30,31].…”

Section: Discussionmentioning

confidence: 99%

Early manifestation of cardiovascular disease risk factors in offspring of mothers with previous history of gestational diabetes mellitus

Lee

Jang

Park³

et al. 2007

Diabetes Research and Clinical Practice

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The relationship of body mass index and blood pressure in primary care pediatric patients

Cited by 227 publications

References 11 publications

Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country

Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country

Increased Serum Uric Acid Levels Blunt the Antihypertensive Efficacy of Lifestyle Modifications in Children at Cardiovascular Risk

Early manifestation of cardiovascular disease risk factors in offspring of mothers with previous history of gestational diabetes mellitus

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