Body mass index in primary and secondary pediatric hypertension

Abstract

The objectives of this study were (1) to determine the relationship of body mass index (BMI) to primary or secondary hypertension in children and adolescents and (2) to assess BMI at the age of onset of hypertension in children and adolescents. Patient demographics, BMI, family history, presentation of disease, etiology of hypertension, medication, laboratory data, and findings from other procedures were recorded for all patients with hypertension followed in the Pediatric Nephrology Clinic at Children's Hospital, Columbus, Ohio, over a 4-year period. In total, 314 patients were studied: 218 with primary hypertension and 96 with secondary hypertension. Our patient population (166 males, 148 females) was diverse in age (13+/-6.3 years) and ethnicity (237 Caucasians, 54 African-Americans, 23 other). BMI was greater in patients with primary (27.5+/-9.2 kg/m2) versus secondary (23.9+/-9.3 kg/m2) hypertension (P=0.002). Children with primary hypertension with an increased BMI presented at an earlier age than children with secondary hypertension and an increased BMI. The age of onset (10.5+/-2.6 years) in primary hypertension was related to increased BMI (r=0.12, P=0.001); however, there was no relationship between BMI and age of onset of secondary hypertension (P=0.21). Children whose family members had essential hypertension had increased BMI compared with children without a family history of essential hypertension. Based on the logistic regression model constructed from our data, the likelihood of primary versus secondary hypertension was influenced by the presence of family history of hypertension independent of presence of obesity in the child. In conclusion, increased BMI is more common in children with primary than secondary hypertension; earlier onset of primary hypertension in the pediatric population was associated with increased BMI; the assessment of BMI is important in the evaluation of secondary as well as primary hypertension; the role of obesity in the development of secondary as well as primary hypertension in children merits further study.

Hypertension Screening During Ambulatory Pediatric Visits in the United States, 2000–2009

“…Although specific circumstances at some visits may have rendered blood pressure measurement impractical or unfeasible, we were unable to determine from our data why blood pressure was not measured at 16% of these visits. Several studies suggest that overweight/obese children have an elevated risk of hypertension, [23][24][25][26] and our finding suggests that most physicians who diagnose overweight/obesity also recognize the importance of screening these patients.…”

Circadian blood pressure rhythm in normotensive offspring of hypertensive parents

“…In the study by Robinson et al [10], the reported incidence of a positive family history among children with essential hypertension was 51%, while in the study by Flynn it amounted to 86.2% [1].…”

Associação do índice de massa corporal e da resistência à insulina com síndrome metabólica em crianças brasileiras

“…The higher prevalence of hypertensive individuals in the higher HOMA percentiles strengthens the hypothesis that excessive body fat can promote increase in blood pressure 4,8 . Mean values of body fat content and fasting insulin were higher in children classified in the upper HOMA quartile and in the obese group, as described elsewhere 28,[32][33][34] . The role of the insulin resistance in the onset of hypertension remains controversial.…”