Objective: Recent studies have reported an increasing prevalence of childhood hypertension. Obesity is probably the most important risk factor. The relationship between hypertension and BMI in children has not been studied in Ankara, which is the second largest city in Turkey. Design: Cross-sectional study analysing direct data on height, weight and blood pressure of students. Setting: Population-based study in Ankara, the capital city of Turkey. Subjects: In three schools, 2826 students aged 7-12 years. Results: The overall prevalence of hypertension was 7·9 %. Among the 222 hypertensive children, 124 (56 %) were boys and ninety-eight (44 %) were girls (P = 0·40). In the whole group, 3·6 % had only systolic hypertension, 0·7 % had only diastolic hypertension and 3·5 % had both systolic and diastolic hypertension. The prevalences of overweight and obesity were both 13·9 %. BMI was significantly correlated with blood pressure (P < 0·001). Overweight and obesity were more common in boys (P < 0·001). Conclusions: Hypertension was more common than has been reported in other studies. Blood pressure measurement should be routine and frequent in children, especially obese children.
KeywordsChildren Blood pressure BMI Hypertension ObesityHypertension (HT) is the worldwide number-one risk factor for preventable death. In Turkey the overall prevalence of HT is 31·8 %, and only 40·7 % of those with HT are aware that they have it (1) . HT is believed to result from obesity, which is exacerbated by a high-energy, high-fat and highsalt diet, inadequate exercise and stress (2)(3)(4) . Childhood HT risk factors increase the risk of HT in adulthood (5,6) . Systolic blood pressure (SBP) elevation in childhood predicts arterial stiffness in young adults (7,8) . Increased carotid intima-medial thickness predicts cardiovascular events (9) . Diastolic blood pressure (DBP) is particularly important in monitoring blood pressure (BP) in younger individuals (10) . The prevalence of obesity has increased rapidly in all age groups (11) . From 1980 to 2005, in the USA the prevalence of obesity has increased by 40 % in children and adolescents (12,13) . Overweight predisposes children to the health problems of obesity in adulthood, including HT, dyslipidaemia, impaired glucose metabolism, hyperinsulinaemia, obstructive sleep apnoea, and orthopaedic and psychosocial problems (14) . High childhood BP predicts CVD in adulthood, and HT plus high BMI predicts even worse CVD in adulthood (15) . The risk of obesity is related to factors in the antenatal environment, the early postnatal years, the adiposity rebound (at 5-6 years of age) and puberty (16) .The relationship between HT and BMI in children has not been studied in Ankara, which is the second largest and the capital city in Turkey. We measured height, weight and BP in 2826 students, aged 7-12 years, in Ankara, Turkey.
MethodThe study was approved by the Provincial Health Directorate of Ankara and the Ethics and Research Committee of Diskapi Yildirim Beyazit Training and Research Ho...