Trends in Adolescents Obesity and the Association between BMI and Blood Pressure: A Cross-Sectional Study in 714,922 Healthy Teenagers

Chorin, Ehud; Hassidim, Ayal; Hartal, Michael; Havakuk, Ofer; Flint, Nir; Ziv‐Baran, Tomer; Arbel, Yaron

doi:10.1093/ajh/hpv007

Cited by 69 publications

(56 citation statements)

References 18 publications

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“…Nevertheless, the study population includes substantial diversity in race and ethnicity. 24 In addition, in our study population 16% were overweight and 16% were obese, which is similar to the prevalence of overweight (15%) and obesity (17%) recently reported in the National Health and Nutrition Examination Survey. 1,25 Third, some have questioned the accuracy of BP, height, and weight measurements obtained in the course of routine clinical care.…”

Section: Discussionsupporting

confidence: 90%

“…This finding is consistent with previous studies showing a strong, positive association between BMI and blood pressure 11,[21][22][23] and a recent meta-analysis showing that obese and overweight children have higher SBP and DBP compared with healthy weight children age 5 to 15 years. 16,24 In general, children and adolescents had similar trends in changes in BP 6 …”

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confidence: 97%

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Change in Weight Status and Development of Hypertension

et al. 2016

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To examine the association of BMI percentile and change in BMI percentile to change in blood pressure (BP) percentile and development of hypertension (HTN). METHODS:This retrospective cohort included 101 606 subjects age 3 to 17 years from 3 health systems across the United States. Height, weight, and BPs were extracted from electronic health records, and BMI and BP percentiles were computed with the appropriate age, gender, and height charts. Mixed linear regression estimated change in BP percentile, and proportional hazards regression was used to estimate risk of incident HTN associated with BMI percentile and change in BMI percentile. RESULTS:The largest increases in BP percentile were observed among children and adolescents who became obese or maintained obesity. Over a median 3.1 years of follow-up, 0.3% of subjects developed HTN. Obese children ages 3 to 11 had twofold increased risk of developing HTN compared with healthy weight children. Obese children and adolescents had a twofold increased risk of developing HTN, and severely obese children had a more than fourfold increased risk. Compared with those who maintained a healthy weight, children and adolescents who became obese or maintained obesity had a more than threefold increased risk of incident HTN. CONCLUSIONS:We observed a strong, statistically significant association between increasing BMI percentile and increases in BP percentile, with risk of incident HTN associated primarily with obesity. The adverse impact of weight gain and obesity in this cohort over a short period underscores the early need for effective strategies for prevention of overweight and obesity. Research, Kaiser Permanente Colorado, Denver, Colorado; e Department of Pediatrics, Kaiser Permanente San Francisco, San Francisco, California; and f Division of Research, Kaiser Permanente Northern California, Oakland, California Dr Parker conceptualized the study design, assembled the data set, conducted all analyses, and drafted the initial manuscript; Dr Sinaiko conceptualized the overall study that developed these data, assisted in the development of the current study, and edited the manuscript; Dr Kharbanda contributed to study conceptualization and design and critically reviewed and provided feedback on the manuscript; Dr Margolis contributed to the study design and provided critical review for drafts of the manuscript; Drs Daley and Sherwood and Ms Trower contributed to the data collection and analysis and critically reviewed the fi nal manuscript; Dr Greenspan contributed to data collection and critically reviewed and provided feedback on the manuscript; Dr Lo contributed to the cohort assembly and data collection, critically reviewed study results, and provided content edits to the manuscript; Dr Magid participated in assembling the data set and reviewed study results and the initial manuscript; Dr O'Connor conceptualized the overall study and development of the current study, reviewed study results, and critically reviewed the manuscript; and all authors approved the...

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Section: Discussionsupporting

confidence: 90%

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confidence: 97%

Change in Weight Status and Development of Hypertension

et al. 2016

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“…8 In Israel, the age-standardized incidence declined to a rate of 9.7 per 100,000 in 2012, 9,10 with a high incidence of gastric cancer among immigrants from the former Soviet Union (FSU). 9 In light of the increasing prevalence of adolescent obesity in Israel, 2,12,13 concern about gastric cancer among immigrants from the FSU, 11 and a report on the association of the BMI with NCGC, 8 we expanded our previous research on the association between the measured BMI, country of birth, and residential socioeconomic status (SES) in adolescence and the risk of gastric cancer among men. 9 In light of the increasing prevalence of adolescent obesity in Israel, 2,12,13 concern about gastric cancer among immigrants from the FSU, 11 and a report on the association of the BMI with NCGC, 8 we expanded our previous research on the association between the measured BMI, country of birth, and residential socioeconomic status (SES) in adolescence and the risk of gastric cancer among men.…”

Section: Introductionmentioning

confidence: 99%

“…11 Because of the worldwide immigration of Jews, Israel provides valuable opportunities for epidemiological studies. 9 In light of the increasing prevalence of adolescent obesity in Israel, 2,12,13 concern about gastric cancer among immigrants from the FSU, 11 and a report on the association of the BMI with NCGC, 8 we expanded our previous research on the association between the measured BMI, country of birth, and residential socioeconomic status (SES) in adolescence and the risk of gastric cancer among men. 14 The current study incorporates data for women and updates our cancer registry linkage data, and thus the number of incident NCGC cases has been considerably enlarged from 130 to 515.…”

Section: Introductionmentioning

confidence: 99%

Body mass index at adolescence and risk of noncardia gastric cancer in a cohort of 1.79 million men and women

Levi

Kark

Twig

et al. 2017

Cancer

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“…We found that LVH phenotype was significantly associated with higher body size, triglycerides, and arterial thickening. From previous studies, we know that LVH is prevalent among obese children and is seen in association with both elevated BP and without elevated BP . Therefore, it is not surprising that even in children with EH in our study, obesity plays a role in the development of LVH.…”

Section: Discussionmentioning

confidence: 49%

Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

Gupta-Malhotra

Hashmi

Poffenbarger

et al. 2015

J of Clinical Hypertension

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Our aim was to determine the risk factors associated with left ventricular hypertrophy (LVH) among 89 untreated children with primary hypertension (HTN). Clinic hypertension was confirmed by 24-hour ambulatory BP monitoring. Left ventricular mass index was calculated as LVM (g)/height (m) 2.7, and LVH was defined as LVMI >95th percentile. Children with (n = 32) and without LVH (n = 57) were compared. Both obesity and systolic BP were independently associated with LVH, with a higher contribution by the BMI. Obesity contributed significantly, with a nearly 9 fold increased risk of LVH. There was evidence of effect modification by the presence or absence of obesity on the relationship between systolic BP and LVH, whereby the relationship existed mainly in the non-obese rather than the obese children. Hence, to achieve reversal of LVH, clinicians should take into account both BP control and weight management.

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Trends in Adolescents Obesity and the Association between BMI and Blood Pressure: A Cross-Sectional Study in 714,922 Healthy Teenagers

Abstract: BMI in adolescents is significantly associated with systolic blood pressure and diastolic blood pressure in both genders and in both the normal weight and overweight groups. There has been consistent trend of increasing BMI values over recent years.

Cited by 69 publications

References 18 publications

Change in Weight Status and Development of Hypertension

Change in Weight Status and Development of Hypertension

Body mass index at adolescence and risk of noncardia gastric cancer in a cohort of 1.79 million men and women

Left Ventricular Hypertrophy Phenotype in Childhood‐Onset Essential Hypertension

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