Association between obesity and the severity of ambulatory hypertension in children and adolescents
Authors:
K. Babinská 1; L. Kovács 1; V. Jankó 1; T. Dallos 1; J. Feber 2
Authors‘ workplace:
2. detská klinika, Lekárska fakulta Univerzity Komenského a Detskej fakultnej nemocnice s poliklinikou, Bratislava, Slovenskoprednosta prof. MUDr. L. Kovács, DrSc., MPH
1; Division of Nephrology, Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Canadaprednosta J. Feber, MD, FRCPC
2
Published in:
Čes-slov Pediat 2014; 69 (2): 67-76.
Category:
Original Papers
Výsledky pôvodne publikované v časopise Journal of the American Society of Hypertension [28] sa v danom článku uvádzajú na základe Vancouverskej dohody editorov svetových lekárskych časopisov o dvojjazyčnej publikácii [29, 30] s písomným súhlasom vydavateľa.
Overview
Introduction and methods:
The goal of our study was to analyze the association between obesity and the severity of ambulatory hypertension in obese children. A total of 109 patients with primary obesity ages 7 to 18 years (mean ± SD age 14.1±3.1) were enrolled. Patients were divided into three groups according to body mass index (BMI) Z-scores: group 1 (n=27): BMI >1.65 and <3.28 standard deviation scores (SDS); group 2 (n=55): BMI >3.29 and <4.91 SDS; group 3 (n=27): BMI >4.92 SDS. Definition and staging of ambulatory hypertension was based on blood pressure (BP) levels and BP load, obtained from ambulatory BP monitoring (ABPM).
Results:
Only 24% of individuals had ambulatory normotension, 25% had ambulatory prehypertension, 3% had hypertension, and 48% had severe ambulatory hypertension (BP load over 50%). The severity of hypertension increased significantly with the degree of obesity (P=0.0027). Daytime systolic (SDS=0.32, 1.24, 1.86), diastolic (SDS= -0.42, 0.56, 0.93), and mean arterial (SDS= -0.01, 0.85, 1.36) BPs increased significantly with increased BMI, whereas the nighttime pressure remained elevated regardless of the degree of obesity. Isolated nighttime hypertension was observed in 25% of patients and 38% were classified as nondippers.
Conclusion:
Almost 50% of children with obesity and hypertension detected on ABPM suffer from severe ambulatory hypertension. BMI is associated with the severity of ambulatory hypertension and the increase of daytime BP.
Key words:
blood pressure, children and adolescents, hypertension, obesity
Sources
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
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