Hypertension. 2002;40:441-447
Published online before print August 26, 2002, doi: 10.1161/01.HYP.0000032940.33466.12
Published online before print August 26, 2002, doi: 10.1161/01.HYP.0000032940.33466.12
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(Hypertension. 2002;40:441.)
© 2002 American Heart Association, Inc.
Brief Review |
Obesity Hypertension in Children
A Problem of Epidemic Proportions
From the Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas-Houston Medical School (J.S.), Houston, Tex; and Division of Cardiology, Department of Pediatrics, University of Cincinnati, College of Medicine and the Children’s Hospital Medical Center (S.D.), Cincinnati, Ohio.
Correspondence to Jonathan M. Sorof, MD, Associate Professor, Division of Pediatric Nephrology and Hypertension, University of Texas-Houston, Medical School, 6431 Fannin St, Rm 3.124, Houston, TX 77030. E-mail jonathan.m.sorof{at}uth.tmc.edu
Obesity has become an increasingly important medical problem in children and adolescents. In national surveys from the 1960s to the 1990s, the prevalence of overweight in children grew from 5% to 11%. Outcomes related to childhood obesity include hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, nonalcoholic steatohepatitis, obstructive sleep apnea, orthopedic problems, and psychosocial problems. Once considered rare, primary hypertension in children has become increasingly common in association with obesity and other risk factors, including a family history of hypertension and an ethnic predisposition to hypertensive disease. Obese children are at approximately a 3-fold higher risk for hypertension than nonobese children. In addition, the risk of hypertension in children increases across the entire range of body mass index (BMI) values and is not defined by a simple threshold effect. As in adults, a combination of factors including overactivity of the sympathetic nervous system (SNS), insulin resistance, and abnormalities in vascular structure and function may contribute to obesity-related hypertension in children. The benefits of weight loss for blood pressure reduction in children have been demonstrated in both observational and interventional studies. Obesity in childhood should be considered a chronic medical condition that is likely to require long-term management. Ultimately, prevention of obesity and its complications, including hypertension, is the goal.
Key Words: hypertension, obesity • children • epidemiology • cardiovascular diseases • risk factors
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