Association between general and central adiposity and development of hypertension in early childhood

Eur J Prev Cardiol. 2019 Aug;26(12):1326-1334. doi: 10.1177/2047487319839264. Epub 2019 Jun 12.

Abstract

Objectives: To evaluate the association of general and abdominal obesity with high blood pressure in young children.

Methods: A longitudinal study including 1796 participants from the Madrid region (Spain) with baseline at age 4 years and a follow-up 2 years later. Blood pressure, body mass index and waist circumference were measured during a physical examination. We evaluated the association between obesity at baseline and weight changes between the ages of 4 and 6 years and high blood pressure. Data were analysed using linear and logistic regressions adjusted for covariates.

Results: Obese 4 year olds (general or abdominal obesity) experienced an average 4-5 mmHg increase in systolic blood pressure and a 2.5-3 mmHg increase in diastolic blood pressure by the age of 6 years. Compared to children maintaining a non-excess weight (based on body mass index) during follow-up incident and persistent cases of excess weight (overweight or obesity) had an odds ratio (OR) for high blood pressure of 2.49 (95% confidence interval (CI) 1.50-4.13) and OR 2.54 (95% CI 1.27-5.07), respectively. Regarding abdominal obesity we estimated OR 2.81 (95% CI 0.98-8.02) for incident cases and OR 3.42 (95% CI 1.38-8.49) for persistent cases. Similar estimates for the waist-height ratio were observed. Individuals who experienced remission to non-excess weight did not have an increased risk of high blood pressure.

Conclusions: We observed an increased risk for high blood pressure among 4-year-olds who presented with persistent or incident cases of excess weight (body mass index) or abdominal obesity after 2 years of follow-up. Children with excess weight or obesity at baseline who remitted to non-excess weight did not exhibit an increased risk of high blood pressure.

Keywords: Childhood; abdominal obesity; arterial hypertension; obesity.

MeSH terms

  • Adiposity*
  • Age Factors
  • Arterial Pressure*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Incidence
  • Longitudinal Studies
  • Male
  • Obesity, Abdominal / diagnosis
  • Obesity, Abdominal / epidemiology*
  • Obesity, Abdominal / physiopathology
  • Pediatric Obesity / diagnosis
  • Pediatric Obesity / epidemiology*
  • Pediatric Obesity / physiopathology
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology