Obese youths have a nearly six fold risk of hypertension, according to research in more than 22 000 young people from the PEP Family Heart Study presented at ESC Congress today by Professor Peter Schwandt from Germany.
Professor Schwandt said: "The prevalence of hypertension and obesity in children and adolescents is continuing to rise in most high and middle-income countries. Because adiposity is considered a driving force for cardiovascular disease, we examined whether elevated blood pressure was associated with body fat distribution in young people."
The current study included 22 051 children and adolescents from the PEP (Prevention Education Program) Family Heart Study (1). In each participant, the researchers measured blood pressure, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), skinfold thickness (SFT) and percent body fat (%BF).
Professor Schwandt said: "These measures are simple, inexpensive, risk free and can be used in offices, schools and at home. However, they must be performed correctly and age and gender specific cut-off values have to be used in growing children and adolescents." (figure 1) (2)
Prehypertension was defined as a blood pressure reading between the 90th and 95th percentile of the blood pressure curve for children and adolescents, while hypertension was a blood pressure reading over the 95th percentile. The diagnosis was based on several measurements on separate days and on repeated estimations with the child sitting quietly for five minutes. The researchers used an adequate cuff size for the arm in the correct position.
The researchers found that compared with normal weight children and adolescents, the risk of prehypertension was significantly higher in youths with an elevated BMI (3). The risk was 1.6 fold higher in overweight and 2.4 fold higher in obese boys, and 1.8 fold higher in overweight and 3.3 fold higher in obese girls.
The significant associations with adverse fat patterning were even stronger for the risk of hypertension. In obese boys the odds ratio (OR) was 5.9 and in obese girls 4.3. Professor Schwandt said: "We found that obese boys had a nearly six fold increased risk of hypertension compared to normal weight boys. In obese girls the risk was more than four times greater than their normal weight counterparts."
The prevalence of elevated blood pressure increased in boys and girls as body weight went up (figure 2). The prevalence of prehypertension/hypertension in normal weight, overweight and obese youths was 13.2%/5.7%, 18.3/10.4% and 21.9/18.6% in boys and 12.9/5.0% 18.7/9.1% and 24.9/24.4% in girls, respectively.
Professor Schwandt said: "Our study clearly shows that the fatter young people are, the greater their risk of prehypertension and hypertension. Any weight loss they can achieve will help reduce their risk."
The researchers also found increased risk of hypertension with elevated SFT and %BF measurements, (4) and abdominal adiposity (5).
Professor Schwandt concluded: "General and abdominal adiposity, estimated using simple and inexpensive methods, are already significantly associated with prehypertension and hypertension in children and adolescents. This is of great importance because of the ongoing rise in the prevalence of hypertension and overweight/obesity in young people and the tracking of childhood overweight into adulthood."
Figure 1: Growth curves for % body fat in boys and girls (2)
Figure 2: Prevalence of normal blood pressure, prehypertension and hypertension in 22 051 children and adolescents according to their weight groups
(1) The PEP (Prevention Education Program) Family Heart Study is a prospective community-based observational study which was performed from 1994 to 2008 in Nuremberg, Germany. The aim of the study is to assess cardiovascular disease (CVD) risk factors, examine whether sustained healthy lifestyles can be implemented in 3 268 healthy families, and evaluate associations between lifestyle change and CVD risk factors in 24 927 parents and their 23 740 children aged 3-18 years.
(2) Schwandt P, von Eckardstein A, Haas GM. Percentiles of percentage body fat in German children and adolescents: an international comparison. Int J Prev Med. 2012 Dec;3(12):846-852.
(3) Normal weight, overweight and obesity were defined using the BMI growth curve for children and adolescents. Normal weight was a BMI less than the 85th percentile, overweight was a BMI between the 85th and 95th percentile, and obesity was a BMI over the 95th percentile.
(4) When the researchers looked at SFT measurements, they found that if the sum of subscapular plus triceps SFT was above 35 mm, the risk of hypertension was 5.8 fold in boys and 3.4 fold in girls. The risk increased to 5.6 fold in boys and 3.4 fold in girls when they also had a %BF above the 95th percentile.
(5) Abdominal adiposity predicted a 3 to 4 fold risk of hypertension. A WC above the 90th percentile increased the risk by 3.5 in boys and 3.1 in girls, while a WHtR greater than 0.5 increased risk by 3.9 in boys and 3.8 in girls.
Notes to editor
The PEP Family Heart Study is continuously supported by the Foundation for the Prevention of Atherosclerosis, Nuremberg, Germany.
Authors: ESC Press Office
Tel: +34 670 521 210 (ESC Spokesperson Coordinator – Tanya Kenny)
About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2014
ESC Congress is currently the world's largest international congress in cardiovascular medicine. ESC Congress 2014 takes place 30 August to 3 September at the Fira Gran Via congress centre in Barcelona, Spain.
This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2014. The press release has been written by the investigator and edited by the ESC and does not necessarily reflect the opinion of the European Society of Cardiology.
ESC Press Office | Eurek Alert!
New study: How stable is the West Antarctic Ice Sheet?
09.02.2016 | Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung
Online shopping might not be as green as we thought
08.02.2016 | University of Delaware
Exceeding critical temperature limits in the Southern Ocean may cause the collapse of ice sheets and a sharp rise in sea levels
A future warming of the Southern Ocean caused by rising greenhouse gas concentrations in the atmosphere may severely disrupt the stability of the West...
Indications of light-induced lossless electricity transmission in fullerenes contribute to the search for superconducting materials for practical applications.
Superconductors have long been confined to niche applications, due to the fact that the highest temperature at which even the best of these materials becomes...
Researchers at King’s College London and the Wellcome Trust Sanger Institute in the United Kingdom have for the first time demonstrated a direct link between the Wbp2 gene and progressive hearing loss. The scientists report that the loss of Wbp2 expression leads to progressive high-frequency hearing loss in mouse as well as in two clinical cases of children with deafness with no other obvious features. The results are published in EMBO Molecular Medicine.
The scientists have shown that hearing impairment is linked to hormonal signalling rather than to hair cell degeneration. Wbp2 is known as a transcriptional...
Pollens, the bane of allergy sufferers, could represent a boon for battery makers: Recent research has suggested their potential use as anodes in lithium-ion batteries.
"Our findings have demonstrated that renewable pollens could produce carbon architectures for anode applications in energy storage devices," said Vilas Pol, an...
Automobiles increase the mobility of their users. However, their maneuverability is pushed to the limit by cramped inner city conditions. Those who need to...
09.02.2016 | Event News
02.02.2016 | Event News
26.01.2016 | Event News
09.02.2016 | Event News
09.02.2016 | Materials Sciences
09.02.2016 | Power and Electrical Engineering