Association of neck circumference and high blood pressure in children and adolescents: a case–control study

Abstract

BackgroundHigh blood pressure (BP) is a serious, common and growing global public health problem. The aim of this study was to evaluate the associations between high NC (neck circumference) alone and in combinations with BMI (body mass index), WC (waist circumference), and high BP among Lithuanian children and adolescents aged 12 to 15 years.MethodsAn epidemiological case–control study was performed between May 2012 and November 2013. NC, WC, hip circumference (HC), mid-upper arm circumference (MUAC), body height, weight, and BP were measured. The participants with high BP (≥90th percentile) were screened on two separate occasions. Data on NC, WC, HC, MUAC, BMI, body adiposity index (BAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and BP were analyzed in 1947 children and adolescents aged 12–15 years. Age- and sex-adjusted odds ratios (aORs) with 95 % confidence intervals (CI) for the associations were estimated using multivariate logistic regression models.ResultsThe prevalence rates of prehypertension (BP ≥90th– < 95th percentile) and hypertension (BP ≥95th percentile) was 6.3 and 25.1 %, respectively. The overall prevalence of high NC (if NC was in the ≥90th percentile), overweight/obesity (as measured by BMI), and abdominal overweight/obesity (if WC was in the ≥75th percentile) were 14.3, 15.8, and 13 %, respectively. After adjustment for age and sex, NC in the ≥90th percentile was significantly associated with an increased risk of elevated BP (prehypertension: aOR = 2.99; 95 % CI, 1.88–4.77; hypertension aOR = 4.05; 95 % CI, 3.03–5.41, and prehypertension/hypertension aOR = 3.75; 95 % CI, 2.86–4.91), compared to the participants with NC in the <90th percentile. Overweight/obesity and abdominal overweight/obesity were also significantly associated with an elevated BP. The combinations including both risk factors (high NC with overweight/obesity, and high NC with abdominal overweight/obesity) showed higher aORs than those with either risk factor alone.ConclusionsHigh NC alone—but particularly in combinations with overweight/obesity and abdominal overweight/obesity—was associated with an increased risk of high BP.

Performance of obesity indices for screening elevated blood pressure in pediatric population

“…Eventually, a total of 9 studies were included in the present review. [18–26] The quality of the included articles is summarized in Table 1.…”

“…[22] The prevalence of hypertension may be overestimated in these studies. Second, some new obesity indices, such as neck circumference [26] and mid-upper arm circumference, [42] had been used to screen elevated BP in children. These obesity indices were not in the meta-analysis because related research is few.…”

Association of neck circumference and obesity with blood pressure among adolescents in urban and rural population in North Tamil Nadu

“…[10] Nafiu et al . have shown a significant positive association of NC and obesity with increase in BP in a cross-sectional study done in children.…”

Neck circumference measurement as a screening tool for obesity in children

“…Renata et al shown association of neck circumference and high blood pressure in children and adolescents. 15 Katz et al had shown that neck to waist ratio, an index of body fat distribution predicts obstructive sleep apnoea in overweight/obese children. 16 Another study conducted in 324 Greek children aged 9 -13 years found that NC was associated with most cardiovascular disease (CVD) risk factors.…”