Trends in Adolescents Obesity and the Association between BMI and Blood Pressure: A Cross-Sectional Study in 714,922 Healthy Teenagers.
BACKGROUND
Seventeen percent of youth in the United States are obese. Obesity has been linked to higher prevalence of hypertension. Past studies were limited by their size and conflicting results. The aim of this study was to analyze trends in adolescents' obesity between 1998 and 2011 and to evaluate the relationship between blood pressure and body mass index (BMI) in healthy adolescents.


METHODS
All adolescents who underwent a medical exam in the years 1998-2011 and were found fit for combat duties in the Israeli Defense Force were included.


RESULTS
The cohort included 714,922 healthy adolescents with 59% of them being males. The mean age was 17.4±0.45 and mean BMI was 22±3.5 kg/m(2). The percentage of overweight adolescents (BMI > 25 kg/m(2)) has increased from 13.2% in 1998 to 21% in 2011, P < 0.001. The mean systolic and diastolic blood pressures increased with increasing BMI deciles (systolic blood pressure by 10mm Hg and diastolic blood pressure by 3-4mm Hg from the 1st decile to the 10th decile, P < 0.001 for both). In multivariate analysis, each increase of 1 unit of BMI was associated with an increased risk of systolic blood pressure above 130 mm Hg in both males (OR = 1.108, 95% CI 1.107-1.110, P < 0.001) and females (OR = 1.114, 95% CI 1.139-1.146, P < 0.001).


CONCLUSIONS
BMI in adolescents is significantly associated with systolic blood pressure and diastolic blood pressure in both genders and in both the normal weight and overweight groups. There has been consistent trend of increasing BMI values over recent years.
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;
Ehud
E
Chorin
Israel Defense Forces Medical Corps, Israel;
Ayal
A
Hassidim
Israel Defense Forces Medical Corps, Israel; The Department of Military Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel;
Michael
M
Hartal
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;
Ofer
O
Havakuk
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;
Nir
N
Flint
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Tomer
T
Ziv-Baran
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel; yaronarbel@gmail.com.
Yaron
Y
Arbel
D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D013997:Time Factors
BMI; Israel; army recruitment; blood pressure; conscripts; gender; hypertension; obesity; teenagers; trends.