Science Integration Division, Center for Chronic Disease Prevention and Control, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, Canada K1A 0K9.
BMC Public Health. 2012 May 29;12:388. doi: 10.1186/1471-2458-12-388.
Canada is facing a childhood obesity epidemic. Elevated blood pressure (BP) is a major complication of obesity. Reports on the impact of excess adiposity on BP in children and adolescents have varied significantly across studies. We evaluated the independent effects of obesity, physical activity, family history of hypertension, and socioeconomic status on BP in a nationally representative sample of children and adolescents.
We analysed cross-sectional data for 1850 children aged 6 to 17 years who participated in the Canadian Health Measures Survey, Cycle 1, 2007-2009. Systolic BP (SBP) and diastolic BP (DBP) were age-, sex-, and height-adjusted to z-scores (SBPZ and DBPZ). Body mass index (BMI) z-scores were calculated based on World Health Organization growth standards. Multivariate linear regression was used to evaluate the independent effects of relevant variables on SBPZ and DBPZ.
For most age/sex groups, obesity was positively associated with SBP. Being obese was associated with higher DBP in adolescent boys only. The BP effect of obesity showed earlier in young girls than boys. Obese adolescents were estimated to have an average 7.6 mmHg higher SBP than normal weight adolescents. BMI had the strongest effect on BP among obese children and adolescents. Moderately active adolescent boys had higher SBP (3.9 mmHg) and DBP (4.9 mmHg) than physically active boys. Family history of hypertension showed effects on SBP and DBP in younger girls and adolescent boys. Both family income and parent education demonstrated independent associations with BP in young children.
Our findings demonstrate the early impact of excess adiposity, insufficient physical activity, family history of hypertension, and socioeconomic inequalities on BP. Early interventions to reduce childhood obesity can, among other things, reduce exposure to prolonged BP elevation and the future risk of cardiovascular disease.
加拿大正面临儿童肥胖症的流行。高血压是肥胖的主要并发症。不同研究对儿童和青少年超重对血压影响的报告差异很大。我们评估了肥胖、身体活动、高血压家族史和社会经济地位对全国代表性儿童和青少年群体血压的独立影响。
我们分析了 2007-2009 年参加加拿大健康测量调查周期 1 的 1850 名 6 至 17 岁儿童的横断面数据。收缩压（SBP）和舒张压（DBP）根据年龄、性别和身高进行了 z 分数（SBPZ 和 DBPZ）调整。体重指数（BMI）z 分数根据世界卫生组织生长标准计算。使用多元线性回归评估相关变量对 SBPZ 和 DBPZ 的独立影响。
对于大多数年龄/性别组，肥胖与 SBP 呈正相关。只有在青少年男孩中，肥胖与较高的 DBP 相关。肥胖对年轻女孩血压的影响比男孩更早。肥胖青少年的 SBP 估计比正常体重青少年高 7.6mmHg。肥胖儿童和青少年中 BMI 对血压的影响最大。中度活跃的青少年男孩的 SBP（3.9mmHg）和 DBP（4.9mmHg）高于活跃的男孩。高血压家族史在年轻女孩和青少年男孩中对 SBP 和 DBP 有影响。家庭收入和父母教育都与幼儿的血压有独立的关联。
我们的研究结果表明，超重、身体活动不足、高血压家族史和社会经济不平等对血压的早期影响。早期干预儿童肥胖症可以减少长时间血压升高和未来患心血管疾病的风险。
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