Overweight, ethnicity, and the prevalence of hypertension in school-aged children.
OBJECTIVE
To describe the current prevalence of pediatric hypertension and the relationships between gender, ethnicity, overweight, and blood pressure.


METHODS
School-based screening was performed in 5102 children (13.5 +/- 1.7 years) from May through November 2002. Age, gender, ethnicity, weight, and height were ascertained, and body mass index (BMI) was calculated as weight (kg)/height (m2). Overweight was defined as BMI > or =95th percentile. Students with blood pressure >95th percentile on the first screening underwent a second screening 1 to 2 weeks later, and then a third screening if blood pressure was >95th percentile at the second screening.


RESULTS
Ethnicity distribution was 44% white, 25% Hispanic, 22% African American, and 7% Asian. Overall, overweight prevalence was 20%, which varied significantly by ethnicity (31% Hispanic, 20% African American, 15% white, and 11% Asian). The prevalence of elevated blood pressure after first, second, and third screenings was 19.4%, 9.5%, and 4.5%, respectively. Elevated blood pressure on first screening was highest among Hispanics (25%) and lowest among Asians (14%). Ethnic differences in the prevalence of hypertension (elevated blood pressure on 3 screenings) were not significant after controlling for overweight. The prevalence of hypertension increased progressively as the BMI percentile increased from < or =5th percentile (2%) to > or =95th percentile (11%). After adjustment for gender, ethnicity, overweight, and age, the relative risk of hypertension was significant for gender (relative risk: 1.50; confidence interval: 1.15, 1.95) and overweight (relative risk: 3.26; confidence interval: 2.50, 4.24).


CONCLUSIONS
These results confirm an evolving epidemic of cardiovascular risk in youth, as evidenced by an increase in the prevalence of overweight and hypertension, notably among ethnic minority children.
Sorof
Jonathan M
JM
Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas Health Science Center, Houston, Texas, USA. jonathan.m.sorof@uth.tmc.edu
Lai
Dejian
D
Turner
Jennifer
J
Poffenbarger
Tim
T
Portman
Ronald J
RJ
D000293:Adolescent; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D013781:Texas / Q000453:epidemiology