Association between general and central adiposity and development of hypertension in early childhood

Abstract

Objectives To evaluate the association of general and abdominal obesity with high blood pressure in young children. Methods A longitudinal study including 1796 participants from the Madrid region (Spain) with baseline at age 4 years and a follow-up 2 years later. Blood pressure, body mass index and waist circumference were measured during a physical examination. We evaluated the association between obesity at baseline and weight changes between the ages of 4 and 6 years and high blood pressure. Data were analysed using linear and logistic regressions adjusted for covariates. Results Obese 4 year olds (general or abdominal obesity) experienced an average 4–5 mmHg increase in systolic blood pressure and a 2.5–3 mmHg increase in diastolic blood pressure by the age of 6 years. Compared to children maintaining a non-excess weight (based on body mass index) during follow-up incident and persistent cases of excess weight (overweight or obesity) had an odds ratio (OR) for high blood pressure of 2.49 (95% confidence interval (CI) 1.50–4.13) and OR 2.54 (95% CI 1.27–5.07), respectively. Regarding abdominal obesity we estimated OR 2.81 (95% CI 0.98–8.02) for incident cases and OR 3.42 (95% CI 1.38–8.49) for persistent cases. Similar estimates for the waist–height ratio were observed. Individuals who experienced remission to non-excess weight did not have an increased risk of high blood pressure. Conclusions We observed an increased risk for high blood pressure among 4-year-olds who presented with persistent or incident cases of excess weight (body mass index) or abdominal obesity after 2 years of follow-up. Children with excess weight or obesity at baseline who remitted to non-excess weight did not exhibit an increased risk of high blood pressure.