title: Association between obesity and the severity of ambulatory hypertension in children and adolescents.
abstract: 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). Only 24% had ambulatory normotension, 25% had ambulatory prehypertension, 3% had hypertension, and 48% had severe ambulatory hypertension. The severity of hypertension increased significantly with the degree of obesity (P = .0027). Daytime systolic, diastolic, and mean arterial 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. 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.
authors.affiliation: 2nd Department of Pediatrics, Comenius University Medical School, University Children's Hospital, Bratislava, Slovakia.
authors.forename: Katarina
authors.initials: K
authors.lastname: Babinska
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kovacs
authors.forename: Viktor
authors.initials: V
authors.lastname: Janko
authors.forename: Tomas
authors.initials: T
authors.lastname: Dallos
authors.forename: Janusz
authors.initials: J
authors.lastname: Feber
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D002940:Circadian Rhythm; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013223:Statistics as Topic