Emily D Parker1, Alan R Sinaiko2, Elyse O Kharbanda3, Karen L Margolis3, Matt F Daley4, Nicole K Trower3, Nancy E Sherwood5, Louise C Greenspan6, Joan C Lo7, David J Magid4, Patrick J O'Connor3. 1. HealthPartners Institute for Education and Research, HealthPartners, Minneapolis, Minnesota; emily.d.parker@healthpartners.com. 2. Department of Pediatrics, and. 3. HealthPartners Institute for Education and Research, HealthPartners, Minneapolis, Minnesota; 4. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; 5. HealthPartners Institute for Education and Research, HealthPartners, Minneapolis, Minnesota; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota; 6. Department of Pediatrics, Kaiser Permanente San Francisco, San Francisco, California; and. 7. Division of Research, Kaiser Permanente Northern California, Oakland, California.
Abstract
OBJECTIVE: To examine the association of BMI percentile and change in BMI percentile to change in blood pressure (BP) percentile and development of hypertension (HTN). METHODS: This retrospective cohort included 101 606 subjects age 3 to 17 years from 3 health systems across the United States. Height, weight, and BPs were extracted from electronic health records, and BMI and BP percentiles were computed with the appropriate age, gender, and height charts. Mixed linear regression estimated change in BP percentile, and proportional hazards regression was used to estimate risk of incident HTN associated with BMI percentile and change in BMI percentile. RESULTS: The largest increases in BP percentile were observed among children and adolescents who became obese or maintained obesity. Over a median 3.1 years of follow-up, 0.3% of subjects developed HTN. Obese children ages 3 to 11 had twofold increased risk of developing HTN compared with healthy weight children. Obese children and adolescents had a twofold increased risk of developing HTN, and severely obese children had a more than fourfold increased risk. Compared with those who maintained a healthy weight, children and adolescents who became obese or maintained obesity had a more than threefold increased risk of incident HTN. CONCLUSIONS: We observed a strong, statistically significant association between increasing BMI percentile and increases in BP percentile, with risk of incident HTN associated primarily with obesity. The adverse impact of weight gain and obesity in this cohort over a short period underscores the early need for effective strategies for prevention of overweight and obesity.
OBJECTIVE: To examine the association of BMI percentile and change in BMI percentile to change in blood pressure (BP) percentile and development of hypertension (HTN). METHODS: This retrospective cohort included 101 606 subjects age 3 to 17 years from 3 health systems across the United States. Height, weight, and BPs were extracted from electronic health records, and BMI and BP percentiles were computed with the appropriate age, gender, and height charts. Mixed linear regression estimated change in BP percentile, and proportional hazards regression was used to estimate risk of incident HTN associated with BMI percentile and change in BMI percentile. RESULTS: The largest increases in BP percentile were observed among children and adolescents who became obese or maintained obesity. Over a median 3.1 years of follow-up, 0.3% of subjects developed HTN. Obesechildren ages 3 to 11 had twofold increased risk of developing HTN compared with healthy weight children. Obesechildren and adolescents had a twofold increased risk of developing HTN, and severely obesechildren had a more than fourfold increased risk. Compared with those who maintained a healthy weight, children and adolescents who became obese or maintained obesity had a more than threefold increased risk of incident HTN. CONCLUSIONS: We observed a strong, statistically significant association between increasing BMI percentile and increases in BP percentile, with risk of incident HTN associated primarily with obesity. The adverse impact of weight gain and obesity in this cohort over a short period underscores the early need for effective strategies for prevention of overweight and obesity.
Authors: Matthew F Daley; Alan R Sinaiko; Liza M Reifler; Heather M Tavel; Jason M Glanz; Karen L Margolis; Emily Parker; Nicole K Trower; Malini Chandra; Nancy E Sherwood; Kenneth Adams; Elyse O Kharbanda; Louise C Greenspan; Joan C Lo; Patrick J O'Connor; David J Magid Journal: Pediatrics Date: 2013-07-01 Impact factor: 7.124
Authors: Bonita Falkner; Samuel S Gidding; Gabriela Ramirez-Garnica; Stacey Armatti Wiltrout; David West; Elizabeth B Rappaport Journal: J Pediatr Date: 2006-02 Impact factor: 4.406
Authors: Jennifer T Fink; Elizabeth M Magnan; Heather M Johnson; Lauren M Bednarz; Glenn O Allen; Robert T Greenlee; Daniel M Bolt; Maureen A Smith Journal: High Blood Press Cardiovasc Prev Date: 2018-10-16
Authors: Eric L Cheung; Cynthia S Bell; Joyce P Samuel; Tim Poffenbarger; Karen McNiece Redwine; Joshua A Samuels Journal: Pediatrics Date: 2017-04-10 Impact factor: 7.124