Effect of obesity and high blood pressure on plasma lipid levels in children and adolescents.

OBJECTIVE

To examine the extent of blood lipid abnormalities in overweight children and to determine whether the prevalence of dyslipidemia is different in overweight children with elevated blood pressure (BP) compared with overweight children with normal BP (NBP).

METHODS

A retrospective, case-control study on 497 patients 2 to 18 years of age at the Nemours Weight Management Clinic of duPont Hospital for Children was conducted to compare the prevalence of abnormal plasma lipid levels in overweight children with high BP with overweight children with NBP.

RESULTS

Elevated BP was detected in 34.7% of the sample; 27.9% had prehypertension (pre-HTN), and 6.8% had HTN. The rates of abnormal plasma lipid levels were high among overweight children with both NBP and HTN. Significantly more boys with high BP had low high-density lipoprotein cholesterol compared with boys with NBP (49.4% vs 27.6%). Significantly more severely obese boys had low high-density lipoprotein cholesterol compared with moderately obese boys (40.3% vs 29.3%). The prevalence of elevated BP was much greater in severely obese boys and girls (46.5% and 39%) than moderately obese boys and girls (28.1% and 23.1%).

CONCLUSIONS

The high prevalence of dyslipidemia found in this overweight sample supports recent recommendations to collect plasma lipid levels in not only overweight children with BP > or =90th percentile but also in all overweight children.