Andrew M South1,2,3, Deepak Palakshappa4,5,6, Callie L Brown4,5. 1. Department of Pediatrics, Wake Forest School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA. asouth@wakehealth.edu. 2. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, USA. asouth@wakehealth.edu. 3. Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston Salem, NC, USA. asouth@wakehealth.edu. 4. Department of Pediatrics, Wake Forest School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA. 5. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, USA. 6. Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
Abstract
OBJECTIVES: To determine the relationship between food insecurity (FI) and high blood pressure (BP) in a national cohort of children and adolescents. METHODS: A cross-sectional analysis of children aged 8-17 years in the 2007-2014 National Health and Nutrition Examination Survey (NHANES; unweighted N = 7125). FI over the preceding 12 months was assessed using the USDA Household Food Security Scale in NHANES. We defined high BP as (i) systolic or diastolic BP ≥ 90% for age < 13 years or ≥ 120/80 mmHg for age ≥ 13 years measured at one visit or (ii) reported hypertension diagnosis or current antihypertensive medication use. We used multivariable logistic regression to determine the association between household and child-specific FI and high BP, controlling for age, sex, race, and household income, accounting for the complex NHANES survey design. RESULTS: The study population was 14.4% black, 21.3% Hispanic, and 49.4% female with a mean age of 12.6 years (SD 2.9). 20.3% had FI and 12.8% had high BP. High BP was more common in household FI vs. food-secure subjects (15.3% vs. 12.1%, p = 0.003). Adjusted analysis confirmed that household FI and child FI were associated with high BP (OR 1.26, 95% CI 1.04-1.54; OR 1.42, 95% CI 1.03-1.96, respectively). CONCLUSIONS: Household and child FI were associated with an increased likelihood of high BP in a large nationally representative cohort of children and adolescents. FI may have a significant impact on cardiovascular health during childhood. Further research is warranted to better define how FI contributes to health disparities.
OBJECTIVES: To determine the relationship between food insecurity (FI) and high blood pressure (BP) in a national cohort of children and adolescents. METHODS: A cross-sectional analysis of children aged 8-17 years in the 2007-2014 National Health and Nutrition Examination Survey (NHANES; unweighted N = 7125). FI over the preceding 12 months was assessed using the USDA Household Food Security Scale in NHANES. We defined high BP as (i) systolic or diastolic BP ≥ 90% for age < 13 years or ≥ 120/80 mmHg for age ≥ 13 years measured at one visit or (ii) reported hypertension diagnosis or current antihypertensive medication use. We used multivariable logistic regression to determine the association between household and child-specific FI and high BP, controlling for age, sex, race, and household income, accounting for the complex NHANES survey design. RESULTS: The study population was 14.4% black, 21.3% Hispanic, and 49.4% female with a mean age of 12.6 years (SD 2.9). 20.3% had FI and 12.8% had high BP. High BP was more common in household FI vs. food-secure subjects (15.3% vs. 12.1%, p = 0.003). Adjusted analysis confirmed that household FI and child FI were associated with high BP (OR 1.26, 95% CI 1.04-1.54; OR 1.42, 95% CI 1.03-1.96, respectively). CONCLUSIONS: Household and child FI were associated with an increased likelihood of high BP in a large nationally representative cohort of children and adolescents. FI may have a significant impact on cardiovascular health during childhood. Further research is warranted to better define how FI contributes to health disparities.
Entities:
Keywords:
Cardiovascular disease; Health disparities; Hypertension; National Health and Nutrition Examination Survey; Pediatrics; Social determinants of health
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