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The relationship of longitudinal screening of blood pressure in school-aged children in Sardinia with excessive weight

Published online by Cambridge University Press:  06 March 2009

Andrea Raffaele Marras
Affiliation:
Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Italy
Pier Paolo Bassareo*
Affiliation:
Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Italy
Massimo Ruscazio
Affiliation:
Clinical Cardiology, Ospedale S.Giovanni di Dio, University of Cagliari, Asl 8, Italy
*
Correspondence to: Pier Paolo Bassareo MD, Center Study for Cardiac Disease in Pediatric Age, University of Cagliari, Via Nizza, 6 – 09129 Cagliari, Italy. Tel: +39070497926; Fax: +39070497926; E-mail: [email protected]

Abstract

Our aim in this part of the Sardinian Hypertensive Adolescents Research Programme, also known as the SHARP study, was to use longitudinal screening over a period of 3 years to search for any relationship between hypertension and excessive weight in a number of Southern Italian students. We also sought to establish if this correlation can change according to the criterion used to define children considered to be overweight.

We studied 839 children, of whom 52.6% were male, defining hypertension as an average blood pressure exceeding the 95th percentile according to previous Italian reference tables. We defined those overweight using different criterions, first those with a body mass index exceeding 25 kilograms per square metres, second those with the index exceeding the 85th percentile, third using the references established by Rolland-Cachera, and fourth according to the relative body weight. The different methods used in defining overweight produced very different estimates, ranging from 8.9% to 26.4%. Our novel findings were that systolic hypertension was present in all children deemed overweight using any of the criterions, but only use of the second and third criterions produced results related significantly to both systolic and diastolic hypertension. In short, excessive weight is strongly associated with systolic hypertension in adolescence. Definition of those being overweight on the basis of a body mass index exceeding the 85th percentile, or using the references established by Rolland-Cachera, proved to be best related with both systolic and diastolic hypertension.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2009

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References

1. Marras, AR, Bassareo, PP, Ruscazio, M. The prevalence of paediatric hypertension, emphasising the need to use specific population references: the Sardinian Hypertensive Adolescents Research Program Study. Cardiol Young 2009; 19: xxxxxx (this issue).CrossRefGoogle Scholar
2. Livingstone, B. Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159: 1434.CrossRefGoogle ScholarPubMed
3. Sorof, J, Daniels, S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002; 40: 441447.CrossRefGoogle ScholarPubMed
4. He, Q, Ding, ZY, Fong, DY, Karlberg, J. Blood pressure is associated with body mass index in both normal and obese children. Hypertension 2000; 36: 165170.CrossRefGoogle ScholarPubMed
5. Cairella, G, Menghetti, E, Scanu, A, et al. Elevated blood pressure in adolescents from Rome, Italy. Nutritional risk factors and physical activity. Ann Ig 2007; 19: 203214.Google ScholarPubMed
6. He, J, Whelton, PK, Appel, LJ, Charleston, J, Klag, MJ. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension 2000; 35: 544549.CrossRefGoogle ScholarPubMed
7. Csàbi, G, Török, K, Jeges, S, Molnàr, D. Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr 2000; 159: 9194.CrossRefGoogle ScholarPubMed
8. Cook, S, Weitzman, M, Auinger, P, Nguyen, M, Dietz, WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003; 157: 821827.CrossRefGoogle ScholarPubMed
9. Baker, JL, Olsen, LW, Sørensen, TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med 2007; 357: 23292337.CrossRefGoogle ScholarPubMed
10. Hohn, AR. Guidebook for Pediatric Hypertension. Futura Publishing Company, New York, 1994.Google Scholar
11. Clark, JA, Lieh-Lai, MW, Sarnaik, A, Mattoo, TK. Discrepance between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Pediatrics 2002; 110: 920923.CrossRefGoogle Scholar
12. Menghetti, E, Virdis, R, Strambi, M, et al. Blood pressure in childhood and adolescence: the Italian normal standards. Study group on Hypertension of the Italian Society of Pediatrics. J Hypertens 1999; 17: 13631372.CrossRefGoogle Scholar
13. Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 12401251.CrossRefGoogle ScholarPubMed
14. Lòpez-Alvarenga, JC, Montesinos-Cabrera, RA, Velàzques-Alva, C, Gonzàles-Barranco, J. Short stature is related to high body fat composition despite body mass index in a Mexican population. Arch Med Res 2003; 34: 137140.CrossRefGoogle Scholar
15. Nader, PR, O’Brien, M, Houts, R, et al. Identifying risk for obesity in early childhood. Pediatrics 2006; 118: 594601.CrossRefGoogle ScholarPubMed
16. Rolland-Cachera, MF, Sempè, M, Guilloud-Bataille, M, Patois, E, Pèquignot-Guggenbuhl, F, Fautrad, V. Adiposity indices in children. Am J Clin Nutr 1982; 36: 178184.CrossRefGoogle ScholarPubMed
17. Tanner, JM, Whitehouse, RH. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 1976; 51: 170179.CrossRefGoogle ScholarPubMed
18. Must, A, Strauss, RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999; 23: 211.CrossRefGoogle ScholarPubMed
19. Dietz, WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518524.CrossRefGoogle ScholarPubMed
20. Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 5: 13501355.CrossRefGoogle Scholar
21. Muntner, P, He, J, Cutler, JA, Wildman, RP, Whelton, PK. Trends in blood pressure among children and adolescents. JAMA 2004; 291: 21072113.CrossRefGoogle ScholarPubMed