Risk of Hypertension High for Overweight and Obese Children

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High weight and hypertension come hand in hand.  Generally, youth with diagnosed hypertension are overweight.  In this latest study, researchers from Kaiser Permanente Southern California, found overweight youth are likely to develop hypertension.  The study was published in The Journal of Clinical Hypertension in October 2013.

Kaiser Permanente

Kaiser Permanente conducted a transformational health research study using their electronic records. They are able to do a large study of this kind because Kaiser Permanente contains the largest private patient-centered electronic health record system in the world called HealthConnect.  This multifaceted system securely connects 9.1 million patients to 17,000 physicians in 611 medical offices and 37 hospitals all over the United States. Moreover, it also provides research scientists with one of the most prolific collections of medical data for research studies or discoveries that help shape future health care.

Researchers examined the records of almost 250,000 children aged 6 to 17 years.  The timeline for the research was January 1, 2007 to December 31, 2009.  The study looked at the first four consecutive blood pressures measured routinely as part of a well child appointment or clinical care during the 36-month time period. Researchers used sex specific BMI-for-age growth charts to classify the groups as overweight, moderately obese, and extremely obese.

Researchers found the heavier the child, the higher the risk for developing hypertension.  Children and adolescents who were overweight are twice as likely as their normal-weight peers to have hypertension.  If they are moderately obese, youths have a four times higher risk for developing hypertension.  If a child or youth was classified as extremely obese, he is 10 times more likely to develop hypertension.  10 percent of youths who were classified as extremely obese had hypertension and almost half had occasional blood pressure measurements in the hypertensive range. 

Elevated Blood Pressure Increasing among Children

Previous studies have shown 1 to 5 percent of youth have hypertension. In a recent study published in the American Heart Association Journal Hypertension, researchers found that the risk of elevated blood pressure among youth rose 27 percent during the thirteen-year period.  This causes concerns to public health officials as high blood pressure is a risk factor for stroke, heart disease and kidney failure.

Researchers are attributing this rise in elevated blood pressure due to higher body mass, larger waistlines, and elevated sodium intake. Despite dietary recommendation, daily sodium intake continues to go up.  Americans take in 3,400 milligrams of sodium daily.  This amount almost doubles the American Heart Association recommendation of 1500 milligrams or less.  More than 80% of the children in the study had a daily sodium intake about 2,300 milligrams.  Children who had the highest sodium intake were 36 percent more likely than those with the lowest intake to have elevated blood pressure.

The study also found that the children whose waistline measurements or body mass were in the top 25 percent for their age group were twice as likely to have elevated blood pressure as the children in the bottom 25 percent.  This finding is similar to the results discovered in the Kaiser Permanente study.

High Blood Pressure asymptomatic

Corinna Koebnick, PhD, and lead author and researcher at Kaiser Permanente Southern California’s Department of Research and evaluation, explains that the study’s results suggest pediatricians must be vigilant screening for high blood pressure in all overweight and obese children.  If an overweight youth comes in for an examination, blood pressure must be monitored at every visit.  This is important because high blood pressure can often be asymptomatic for many years. 

Matthew F. Daly, MD, pediatrician and researcher at the Institute for Health Kaiser Permanente Colorado advises using the current classifications for overweight and obesity in children to effectively identify at risk children for hypertension. This helps aid the challenge of screening asymptomatic children for hypertension and creates a system to focus on the children with the most need for timely follow up.

Resource:

Kaiser Permanente (2013, October 10). Overweight, obese children face high risk of          hypertension. ScienceDaily. Retrieved October

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