High Blood Pressure in Overweight and Obese Youth: Implications for Screening
Article first published online: 9 OCT 2013
©2013 Wiley Periodicals, Inc.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The Journal of Clinical Hypertension
Volume 15, Issue 11, pages 793–805, November 2013
How to Cite
J Clin Hypertens (Greenwich). 2013;15:793–805. ©2013 Wiley Periodicals, Inc.
- Issue published online: 30 OCT 2013
- Article first published online: 9 OCT 2013
- Manuscript Accepted: 14 AUG 2013
- Manuscript Revised: 9 AUG 2013
- Manuscript Received: 6 JUN 2013
- National Institute of Diabetes and Digestive and Kidney Disorders. Grant Numbers: NIDDK, R21DK085395
- Kaiser Permanente Direct Community Benefit Funds
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.