Leah E. Robinson, Colleen M. Daly, Danielle D. Wadsworth
School of Kinesiology, Auburn University, Auburn, USA.
DOI: 10.4236/health.2013.58A3013   PDF    HTML     5,334 Downloads   8,017 Views   Citations

Abstract

Background: Young children who are overweight and obese may be at a greater risk of hypertension, and those from rural and low socio-economic areas may also exhibit a prevalence of metabolic dysfunction and cardiovascular risk. This study evaluated the relationship of body mass index (BMI) and blood pressure in children from a rural, low socioeconomic community in Alabama. Methods: This cross-sectional study was comprised of young children (aged 5-9 years). BMI (normal, overweight, obese) was assessed using standardized procedures and classified based on the Centers for Disease Control Growth Charts. Blood pressure status (normal, pre-hypertension, hypertension; stage 1 and stage 2) was defined by percentiles of the 2nd and 3rd reading on a single occasion. A MANOVA was used to determine the relationship of BMI to mean blood pressure (i.e., systolic and diastolic). Results: Of the 134 participants (78% non-Hispanic Black), 10 (7.5%) were overweight and 25 (18.7%) were obese. Pre-hypertension and hypertension were detected in 9 (6.7%) and 20 (14.9%) children, respectively. Results indicate that mean systolic and diastolic blood pressure significantly increased with BMI, P < 0.001 and P = 0.028. Conclusion: Hypertension was strongly associated with an unhealthy BMI in these young children from a rural and low-socio-economic community. The findings raise concerns about the growing epidemic of childhood obesity and hypertension in young children and warrant the need to investigate lifestyle behavioral interventions on BMI and blood pressure.

Keywords

Hypertension; Rural Health; Pediatrics; Obesity; Overweight

Share and Cite:

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Ogden, C.L., Carroll, M.D., Curtin, L.R., et al. (2010) Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA, 303, 242-249. doi:10.1001/jama.2009.2012
[2]	Daniels, S.R. (2006) The consequences of childhood overweight and obesity. Future of Children, 16, 47-67. doi:10.1353/foc.2006.0004
[3]	Ebbeling, C.B., Pawlak, D.B. and Ludwig, D.S. (2002) Childhood obesity: Public-health crisis, common sense cure. Lancet, 360, 473-482. doi:10.1016/S0140-6736(02)09678-2
[4]	Raitkari, O.T., Porkka, K.V.K., Rasanen, L., et al. (1994) Clustering and six year cluster-tracking of serum total cholesterol, HDL-cholesterol and diastolic blood pressure &in children and young adults—the cardiovascular risk in young finns study. Journal of Clinical Epidemiology, 47, 1085-1093. doi:10.1016/0895-4356(94)90094-9
[5]	Bao, W., Threefoot, S.A., Srinvasan, S.R., et al. (1995) Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: The Bogalusa heart study. American Journal of Hypertension, 8, 657-665. doi:10.1016/0895-7061(95)00116-7
[6]	Muntner, P., He, J., Cutler, J.A., et al. (2004) Trends in blood pressure among children and adolescents. Pediatrics, 291, 2107-2113.
[7]	Guo, S., Salisbury, S., Roche, A.F., et al. (1994) Cardiovascular disease risk factors and body composition: A review. Nutrition Research, 14, 1721-1777. doi:10.1016/S0271-5317(05)80327-6
[8]	Gerber, L.M. and Stern, P.M. (1999) Relationship of body size and body mass to blood pressure: Sex-specific and developmental influences. The Program in Human Biology, 71, 505-528.
[9]	Eisenmann, J.C. (2004) Physical activity and cardiovascular disease risk factors in children and adolescents: An overview. Canadian Journal of Cardiology, 20, 195-301.
[10]	Luma, G.B. and Spiotta, R.T. (2006) Hypertension in children and adolescents. American Family Physician, 73, 1558-1568.
[11]	Hanevold, C., Waller, J., Daniels, S., et al. and International Pediatric Hypertension Association. (2004) The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: A collaborative study of the International Pediatric Hypertension Association. Pediatrics, 113, 328-333. doi:10.1542/peds.113.2.328
[12]	Andelopoulos, P.D., Milionis, H.J., Maochonis, G., et al. (2006) Relations between obesity and hypertension: Preliminary data from a cross-sectional study in primary schoolchildren: The children study. European Journal of Clinical Nutrition, 60, 1226-1234. doi:10.1038/sj.ejcn.1602442
[13]	Antaei, N., Hosseini, M. and Iranmanesh, M. (2009) The relationship of body mass index and blood pressure in Iranian children <7 years old. Journal of Tropical Pediatrics, 55, 313-317. doi:10.1093/tropej/fmp014
[14]	Moore, W.E., Stephens, A., Wilson, T., et al. (2006) Body mass index and blood pressure screening in a rural public school system: The Healthy kids project. Preventing Chronic Disease, 3, 1-10.
[15]	Savadori, M., Sontrop, J.M., Garg, A.X., et al. (2008) Elevated blood pressure in relation to overweight and obesity among children in a rural Canadian community. Pediatrics, 122, e821-e827. doi:10.1542/peds.2008-0951
[16]	Falkner, B., Gidding, S.S., Ramirez-Garnica, G., et al. (2006) The relationship of body mass index and blood pressure in primary care pediatric patients. Journal of Pediatrics, 128, 195-200. doi:10.1016/j.jpeds.2005.10.030
[17]	Hlaing, W.M., Prineas, R.J. and Zhu, Y. (2006) Tragectory of systolic blood pressure in children and adolescents. Annals of Epidemiology, 16, 11-18. doi:10.1016/j.annepidem.2005.03.006
[18]	Sorof, J.M., Lai, D., Turner, J., et al. (2004) Overweight, ethnicity and the prevalence of hypertension in schoolaged children. Pediatrics, 113, 475-482. doi:10.1542/peds.113.3.475
[19]	Thompson, D.R., Obarzanek, E., Franko, D.L., et al. (2007) Childhood overweight and cardiovascular disease risk factors: The national heart, lung, and blood institute growth and health study. Journal of Pediatrics, 150, 18-25. doi:10.1016/j.jpeds.2006.09.039
[20]	Brown, C.D., Higgins, M., Donato, K.A., et al. (2008) Body mass index and the prevalence of hypertension and dyslipidemia. Obesity Research, 8, 605-619. doi:10.1038/oby.2000.79
[21]	Freedman, D.S., Dietz, W.H., Srinivasan, S.R., et al. (1999) The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa heart study. Pediactrics, 103, 1175-1182. doi:10.1542/peds.103.6.1175
[22]	Rosner, B., Prineas, R., Daniels, S.R., et al. (2000) Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. American Journal of Epidemiology, 151, 1007-1019. doi:10.1093/oxfordjournals.aje.a010129
[23]	Kannel, W.B. (2000) Elevated systolic blood pressure as a cardiovascular risk factor. American Journal of Cardiology, 85, 251-255. doi:10.1016/S0002-9149(99)00635-9
[24]	Chobanian, A.V., Karris, G.L., Black, H.R., et al. (2003) Evaluation, and treatment of high blood pressure seventh report of the joint national committee on prevention detection. Hypertension, 42, 1206-1252. doi:10.1161/01.HYP.0000107251.49515.c2
[25]	Forsen, T., Nissinen, A., Tuomilehto, J., et al. (1999) Growth in childhood blood pressure in Finnish children. Journal of Human Hypertension, 12, 397-402. doi:10.1038/sj.jhh.1000643
[26]	Eisenmann, J.C., Wrede, J. and Heelan, K.A. (2005) Association between adiposity, family history of CHD and blood pressure in 3-8 year-old children. Journal of Human Hypertension, 19, 675-681. doi:10.1038/sj.jhh.1001882
[27]	Field, A.E., Laird, N., Steinberg, E., et al. (2003) Which metric of relative weight best captures body fatness in children? Obesity Research, 11, 1345-1352. doi:10.1038/oby.2003.182