title: Malnutrition is associated with increased blood pressure in childhood.
abstract: OBJECTIVE
  Protein-energy malnutrition remains a major public health problem in many countries. Scanty information is available about the effects of malnutrition during childhood on blood pressure (BP).
  
  
  METHODS
  In a cross-sectional study we assessed the BP of 172 children older than 2 years living in shantytowns in São Paulo city. Ninety-one children were malnourished (height-for-age or weight-for-age Z-score below -1 of the NCHS references); 20 had recovered from malnutrition after an average time of 6.4 years, and 61 were non-malnourished controls.
  
  
  RESULTS
  A greater percentage of children in the malnourished and recovered groups had increased systolic or diastolic BP (>95th percentile of the Update of the 2nd Task Force references) after adjusting for age, sex and height, compared to the controls (29, 20 and 2%, respectively, p < 0.001). Mean diastolic BP, adjusted for age, sex, race, weight, height and birth weight, was significantly increased in malnourished and recovered children compared to controls (65.2 +/- 0.6, 66.5 +/- 1.5, and 61.8 +/- 0.8 mm Hg, respectively, p < 0.01).
  
  
  CONCLUSIONS
  BP is increased in malnourished children and in those who recovered from malnutrition after an average period of 6 years. Malnutrition occurring during childhood may represent a risk factor for increased BP later in life.
authors.affiliation: Division of Nephrology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil. rsesso@nefro.epm.br
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sesso
authors.forename: Genia P
authors.initials: GP
authors.lastname: Barreto
authors.forename: Janaina
authors.initials: J
authors.lastname: Neves
authors.forename: Ana L
authors.initials: AL
authors.lastname: Sawaya
mesh_terms: D000704:Analysis of Variance; D000886:Anthropometry; D001794:Blood Pressure; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications* / Q000503:physiopathology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000209:etiology*; D008297:Male; D012044:Regression Analysis