Childhood Obesity Linked to Hypertension Development

Obese children and adolescents may be more likely to see dangerously high blood pressure.

A recent study published inPediatricsexamined more than 101,000 patients aged 3 to 17 years across 3 US health systems. The authors collected electronic health record information about the patients’ height, weight, and blood pressure, and then computed body mass index (BMI) and blood pressure percentiles.

After about 3 years, 0.3% of the patients developed hypertension. The largest increases in blood pressure percentiles were found among children who were obese over the study period, the authors determined.

Obese patients aged 3 to 11 years had a 2-fold increased risk of developing hypertension than their healthier-weight peers. Severely obese children faced a 4-fold increased risk.

Obese children also had a more than 3-fold increased risk of incident hypertension.

“We observed a strong, statistically significant association between increasing BMI percentile and increases in blood pressure percentile, with risk of incident hypertension associated primarily with obesity,” the researchers concluded.

They noted that the adverse effects of obesity over a short period of time demonstrate how it is important to find effective strategies for preventing unhealthy weight gain. However, education about the potential relationship between hypertension and obesity may not be the best strategy for youth, according to one of the authors.

Research investigator Emily Parker of the HealthPartners Institute told Contemporary Clinic that she doubted that educating young patients about hypertension risks would encourage changes in health behavior. Instead, she advised nurse practitioners and physician assistants working in retail clinics to use other strategies to prevent weight gain among children and adolescents.

One way in which retail clinicians could help is by recommending the Dietary Approaches to Stop Hypertension (DASH) diet, which encourages patients to lower their sodium intake and avoid certain fats while opting for fruits and vegetables, low-fat and nonfat dairy, nuts, beans, lean proteins, and seeds instead.

The DASH diet also promotes eating foods rich in potassium, magnesium, calcium, and fiber. Diets that involve nutrients like calcium and magnesium have been associated with lower blood pressure.

In addition to diet, the Physical Activity Guidelines for Americans advises children to participate in physical activity for at least an hour every day.

Obesity affects 1 in 6 children and adolescents in the United States, according to the US Centers for Disease Control and Prevention (CDC). Childhood and adolescent obesity (patients aged 2 to 19 years) is typically defined as a BMI at or above the 95th percentile of the sex-specific CDC BMI-for-age growth charts.

According to the CDC, some factors that may be contributing to a rise in unhealthy weight include:

• Advertising of unhealthy food
• A lack of safe or appealing areas to be active in communities
• Limited access to healthy food
• Easy access to sugary drinks
• Large portion sizes
• Not enough support for breastfeeding

In addition to the associated risk for hypertension, obesity increases the likelihood of children developing high cholesterol, breathing problems such as sleep apnea and asthma, joint problems, musculoskeletal discomfort, low self-esteem, and psychological stress.