title: Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong, China.
abstract: OBJECTIVE
  Several anthropometric indicators [such as body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)] have been used to investigate the association between adiposity and high blood pressure (BP) in both adults and children. The present study compared the BP levels among children and adolescents with different BMI and WC in a large population in Shandong, China.
  
  
  METHODS
  A total of 38,822 students (19,456 boys and 19,366 girls) aged 7-17 years participated in this study. Height, weight, WC, and BP of all subjects were measured, and BMI was calculated. The prevalence of overweight and obesity was obtained according to the International Obesity Task Force (IOTF) cutoffs; central obesity was defined as WC ≥ 90th percentile (P 90); relatively high BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for age and gender.
  
  
  RESULTS
  Within each BMI categories (normal weight, overweight, and obesity), children and adolescents with WC ≥ P 90 had higher BP levels than those with WC < P 90 (p < 0.01). When BMI and WC were combined, the highest and lowest prevalences of relatively high BP were noted in obese with WC ≥ P 90 group (54.52% for boys and 48.71% for girls) and normal weight with WC < P 90 group (17.00% for boys and 14.13% for girls).
  
  
  CONCLUSIONS
  Children and adolescents with high BMI and high WC might have an increased risk of elevated BP. Our results suggest that the additional measurement of WC is better than BMI alone to help identify high BP risks.
authors.affiliation: Shandong Center for Disease Control and Prevention, 16992 Jingshi Road, Jinan, 250014, Shandong, China, sdcdczyx@163.com.
authors.forename: Ying-Xiu
authors.initials: YX
authors.lastname: Zhang
authors.forename: Shu-Rong
authors.initials: SR
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D012737:Sex Factors; D013334:Students; D055105:Waist Circumference
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