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(Circulation. 2004;110:1832-1838.)
© 2004 American Heart Association, Inc.

Preventive Cardiology

Blood Pressure and Adiposity in Children and Adolescents

Gilles Paradis, MD, MSc, FRCPC; Marie Lambert, MD, FRCPC; Jennifer O’Loughlin, PhD; Claudette Lavallée, MA; Jacinthe Aubin, MA; Edgard Delvin, PhD, FCACB; Emile Lévy, PhD; James A. Hanley, PhD

From the Direction de santé publique de Montréal-Centre (G.P., J.O.), McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (G.P., J.O., J.A.H.), McGill University; Département de pédiatrie (M.L.), Hôpital Ste-Justine and Université de Montréal; Institut de la statistique du Québec (C.L., J.A.); Département de biochimie clinique (E.D.), Hôpital Ste-Justine and Université de Montréal; and Centre de recherche (E.L.), Hôpital Ste-Justine and Département de nutrition, Université de Montréal, Montréal, Québec, Canada.

Correspondence to Gilles Paradis, MD, MSc, FRCPC, Direction de santé publique de Montréal-Centre, 1301 Sherbrooke St East, Montréal (Québec), Canada, H2L 1M3. E-mail gilles.paradis{at}mcgill.ca

Received February 7, 2004; de novo received April 27, 2004; accepted June 8, 2004.

Background— Although obesity is associated with important hemodynamic disturbances, there are few data on population-wide blood pressure (BP) distribution in children and adolescents in this era of endemic pediatric obesity.

Methods and Results— We conducted a school-based survey of a representative sample of youth aged 9, 13, and 16 years in Quebec, Canada. Resting BP was measured with an oscillometric device in 3589 subjects (80% response). Additional measures included height, weight, and subscapular and triceps skinfold thickness, an age-appropriate questionnaire, and a fasting blood draw. Mean (SD) systolic/diastolic BP (SBP/DBP) levels in 9-, 13-, and 16-year-olds were 103 (9)/57 (6), 113 (12)/58 (7), and 124 (14)/61 (7) mm Hg in males and 103 (10)/57 (6), 111 (11)/60 (7), and 114 (11)/62 (7) mm Hg in females. The prevalence of high-normal or elevated SBP was 12%, 22%, and 30% among 9-, 13-, and 16-year-old males, respectively, and 14%, 19%, and 17% among same-aged females. The prevalence of high-normal or elevated DBP was <1%. In multiple linear regression analysis, body mass index was consistently associated with SBP and DBP in all age-gender groups.

Conclusions— Mean SBP and the prevalence of high-normal and elevated SBP are elevated in children and adolescents. Public policy, public health programs, and clinical preventive measures are urgently needed to address the obesity epidemic and its hemodynamic consequences.

Key Words: obesity • hypertension • blood pressure • pediatrics • population

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