Conference Coverage

High blood pressure begins early in overweight children



WASHINGTON – Children as young as 3-5 years old appear to be at risk for developing hypertension if they become overweight or obese as they grow.

Prehypertension was 57% more likely to develop in children who went from being of normal weight to being overweight, and hypertension was almost twice as likely to develop, compared with children who maintained a normal weight, *Dr. Elyse Kharbanda, reported at the annual meeting of the Pediatric Academic Societies.

*Dr. Elyse Kharbanda

The picture was even grimmer for the 10% of children who remained obese during the entire 2.5-year study, said *Dr. Kharbanda of HealthPartners Institute for Education and Research, Bloomington, Minn. Those children were more than twice as likely to develop incident prehypertension and nearly four times as likely to develop incident hypertension.

Her study examined trends in weight and blood pressure among 59,638 children aged 3-17 years. The children were drawn from three large insurance data sets in northern California, Colorado, and Minnesota from the time period of 2007-2010. All of the children had visited a health care facility in their group at least four times during the study period, and all had normal blood pressure at the first visit.

About half (45%) of the children were white, 11% were black, 8% Asian, and 7% Hispanic; other ethnicities made up the remainder of the cohort. Age ranges were 3-5 years (27%), 6-8 years (17%), 9-11 years (21%), 12-14 years (22%), and 15-17 years (13%).

For the study, normal weight was defined as a body mass index in the 5th to less than 85th percentile, while overweight was defined as BMI in the 85th to less than 95th percentile. Obesity was defined as a BMI in the 95th percentile or greater.

At baseline, mean BMI was in the 64th percentile. The children’s mean baseline blood pressure was in the 39th percentile for systolic and 50th for diastolic.

Over the study period, 65% of the children maintained a normal weight, 8% remained overweight, and 10% remained obese. Nine percent of the group increased in weight, either from a healthy weight to overweight, or from overweight to obese. Eight percent of the children lost weight, going from overweight to normal weight or from obese to overweight.

During the study period, there were 16,102 new cases of prehypertension (27%) and 597 cases of incident hypertension (1%).

A multivariate analysis controlled for age, race, study site, and systolic blood pressure at baseline. In the fully adjusted model, compared with children who maintained a healthy weight, those who became overweight or obese were 57% more likely to develop prehypertension. Children who stayed overweight were 49% more likely to develop prehypertension, and those who remained obese were 2.3 times more likely to develop prehypertension. All of the differences were statistically significant.

Children who increased from one weight category to the next were 87% more likely to develop hypertension. The increased risk was 28% for those who stayed overweight and 3.6% for those who remained obese. Again, the changes were statistically significant.

The analysis also found significant differences in progression from prehypertension to hypertension. Children whose weight category increased were 27% more likely to progress, and those who stayed obese, 86% more likely. Children who stayed overweight were not significantly more likely to progress from prehypertension to hypertension, Dr. Kharbanda said.

She had no financial disclosures.

*Correction 5/10/13: The photo and reference to the presenter of the study that originally accompanied this article were incorrect. The presenter of the study was Dr. Elyse Kharbanda, of HealthPartners Institute for Education and Research, Bloomington, Minn.

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