Salvadori Marina, Sontrop Jessica M, Garg Amit X, Truong Jennifer, Suri Rita S, Mahmud Farid H, Macnab Jennifer J, Clark William F
Department of Pediatrics, Children's Hospital, London, Ontario, Canada.
Pediatrics. 2008 Oct;122(4):e821-7. doi: 10.1542/peds.2008-0951.
Childhood overweight and obesity may result in premature onset of cardiovascular risk factors such as hypertension. Rural populations in North America may be at increased risk for overweight. We evaluated whether overweight and obesity were associated with prehypertension and hypertension in a well-characterized population of children in rural Canada.
The study population for this cross-sectional study was composed of children (aged 4-17 years) who were participants of the Walkerton Health Study (Canada) in 2004. Prehypertension and hypertension were defined on the basis of percentiles from the average of 3 blood pressure measures taken on a single occasion. Percentiles for BMI and blood pressure were calculated by using the 2000 Centers for Disease Control and Prevention growth charts. Multinomial logistic regression was used to evaluate the odds for prehypertension and hypertension resulting from overweight and obesity.
Of 675 children (98.7% white), 122 (18.1%) were overweight and 77 (11.4%) were obese. Prehypertension and hypertension were detected in 51 (7.6%) and 50 (7.4%), respectively. After adjustment for family history of hypertension and kidney disease, obesity was associated with both prehypertension and hypertension. Overweight was associated with hypertension but not prehypertension. These associations were observed across the genders and children aged <13 and >or=13 years, except that overweight was not associated with hypertension among girls.
In this population of children who lived in a rural community in Canada, overweight and obesity were strongly associated with elevated blood pressure. Whether blood pressure normalizes with improvements in diet, physical activity, and environment is an area for additional study.
儿童超重和肥胖可能导致心血管危险因素如高血压提前出现。北美农村人口超重风险可能更高。我们评估了在加拿大农村一个特征明确的儿童群体中，超重和肥胖是否与高血压前期及高血压相关。
这项横断面研究的研究人群由2004年参加沃克顿健康研究（加拿大）的4至17岁儿童组成。高血压前期和高血压根据单次测量的3次血压平均值的百分位数来定义。体重指数（BMI）和血压的百分位数通过使用2000年美国疾病控制与预防中心的生长图表来计算。采用多项逻辑回归来评估超重和肥胖导致高血压前期及高血压的几率。
675名儿童（98.7%为白人）中，122名（18.1%）超重，77名（11.4%）肥胖。分别有51名（7.6%）和50名（7.4%）被检测出患有高血压前期和高血压。在对高血压和肾病家族史进行调整后，肥胖与高血压前期及高血压均相关。超重与高血压相关，但与高血压前期无关。这些关联在不同性别以及年龄＜13岁和≥13岁的儿童中均有观察到，不过超重与女孩的高血压无关。
在这个居住在加拿大农村社区的儿童群体中，超重和肥胖与血压升高密切相关。血压是否会随着饮食、身体活动和环境的改善而恢复正常是一个有待进一步研究的领域。
