title: High blood pressure in overweight and obese youth: implications for screening.
abstract: In the absence of evidence-based guidelines for high blood pressure screening in asymptomatic youth, a reasonable strategy is to screen those who are at high risk. The present study aimed to identify optimal body mass index (BMI) thresholds as a marker for high-risk youth to predict hypertension prevalence. In a cross-sectional study, youth aged 6 to 17 years (n=237,248) enrolled in an integrated prepaid health plan in 2007 to 2009 were classified according to their BMI and hypertension status. In moderately and extremely obese youth, the prevalence of hypertension was 3.8% and 9.2%, respectively, compared with 0.9% in normal weight youth. The adjusted prevalence ratios (95% confidence intervals) of hypertension for normal weight, overweight, moderate obesity, and extreme obesity were 1.00 (Reference), 2.27 (2.08-2.47), 4.43 (4.10-4.79), and 10.76 (9.99-11.59), respectively. The prevalence of hypertension was best predicted by a BMI-for-age ≥94th percentile. These results suggest that all obese youth should be screened for hypertension.
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Corinna
authors.initials: C
authors.lastname: Koebnick
authors.forename: Mary Helen
authors.initials: MH
authors.lastname: Black
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Mayra P
authors.initials: MP
authors.lastname: Martinez
authors.forename: Ning
authors.initials: N
authors.lastname: Smith
authors.forename: Beatriz
authors.initials: B
authors.lastname: Kuizon
authors.forename: David
authors.initials: D
authors.lastname: Cuan
authors.forename: Deborah Rohm
authors.initials: DR
authors.lastname: Young
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000639:trends*; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors