Obesity Hypertension in Children

Abstract

Abstract-Obesity has become an increasingly important medical problem in children and adolescents. In national surveys from the 1960s to the 1990s, the prevalence of overweight in children grew from 5% to 11%. Outcomes related to childhood obesity include hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, nonalcoholic steatohepatitis, obstructive sleep apnea, orthopedic problems, and psychosocial problems. Once considered rare, primary hypertension in children has become increasingly common in association with obesity and other risk factors, including a family history of hypertension and an ethnic predisposition to hypertensive disease. Obese children are at approximately a 3-fold higher risk for hypertension than nonobese children. In addition, the risk of hypertension in children increases across the entire range of body mass index (BMI) values and is not defined by a simple threshold effect. As in adults, a combination of factors including overactivity of the sympathetic nervous system (SNS), insulin resistance, and abnormalities in vascular structure and function may contribute to obesity-related hypertension in children. The benefits of weight loss for blood pressure reduction in children have been demonstrated in both observational and interventional studies. Obesity in childhood should be considered a chronic medical condition that is likely to require long-term management. Ultimately, prevention of obesity and its complications, including hypertension, is the goal. Key Words: hypertension, obesity Ⅲ children Ⅲ epidemiology Ⅲ cardiovascular diseases Ⅲ risk factors O besity has become an increasingly important medical problem in children and adolescents. Many of the outcomes associated with obesity that were previously thought of as diseases of adults are now affecting children as well. Outcomes related to childhood obesity include hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, nonalcoholic steatohepatitis, obstructive sleep apnea, and orthopedic problems (such as slipped capital-femoral epiphysis), as well as social and psychological problems. 1 Obesity is also the most common nutritional problem among children in developed countries. This epidemic of pediatric obesity has resulted in great concern regarding the management of obesity and its complications. Although prevention would be an optimum strategy, it may be difficult to identify children at risk of obesity before they become overweight. Even with appropriate preventive approaches, it is likely that many children will become overweight and require treatment to prevent the long-term sequelae of obesity, such as cardiovascular morbidity and mortality. 2 In concert with the increasing prevalence of obesity in children, pediatric hypertension has undergone an epidemiological shift. The conventional wisdom has been that hypertension in children is a relatively rare condition most commonly associated with renal disease. In actuality, secondary hypertension in children resulting from re...

Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country

“…However, the benefits of weight loss for BP reduction in children have been shown in both cohort studies and trials. 3 It was recently shown in a population-based study that children who were overweight at the age of 5 years and had normal weight at the age of 14 years had similar mean BP at the age of 14 years as compared to those with normal weight at both ages. 42 Finally, some factors not considered in this study, such as heart rate, family history of hypertension, birth weight or nutrition factors, could bias or modify the relationship between BMI and BP.…”

“…3 Children with elevated blood pressure (BP) can develop target organ damage, for example, increased carotid intima-media thickness 4 or ventricular hypertrophy, 5 and they are also at increased risk of cardiovascular disease in adulthood. 6 Moreover, BP tracks from childhood to adulthood.…”

Lower Extremity Pain Is Associated With Reduced Function and Psychosocial Health in Obese Children

“…The epidemic of childhood obesity has led to the recognition of obesity-related childhood and adolescent morbidities that are commonly seen in adult-onset obesity such as diabetes, hypertension, cardiovascular disease, and respiratory complications [3,11,27,50]. Obesity-related musculoskeletal comorbidities, including joint pain and lower extremity malalignment, are well characterized among adults [16,17,47].…”

Sex-related Differences in Correlation of Overweight/Obesity Markers to Blood Pressure in Prepubertal Children in Osijek-Baranja County – a Cross-sectional Study

“…This is a significant cognition which shows some kind of protection of developing cardiovascular risk factors in girls compared to the boy at same age, and this protection is not related to female sex hormones, since our study group was in prepubertal phase of sexual maturation. Positive correlation of obesity markers, BMI and WC, to blood pressure, blood glucose concentrations and skin folds confirmed hypothesis that overweight and obesity can precipitate and lead to higher values of measured parameters which are considered to be the indicators of increased risk for developing chronic diseases (27).Recent studies examined relationship of obesity, physical activity and cardio-metabolic risk factors in children, reporting a worsening of risk parameters for cardiovascular disease in overweight and obese children (27,28,29). According to Friedman et al meta-analysis, SBP was higher by 4.54 mmHg in overweight children, and 7.49 mmHg in obese children compared to normal-weight …”