Waist Circumference is Associated with Blood Pressure in Children with Normal Body Mass Index: A Cross-Sectional Analysis of 3,417 School Children

Arq Bras Cardiol. 2017 Dec;109(6):509-515. doi: 10.5935/abc.20170162. Epub 2017 Nov 27.
[Article in English, Portuguese]

Abstract

Background: The prevalence of childhood obesity and associated conditions, such as hypertension, has become a major problem of public health. Although waist circumference (WC) is a marker of cardiovascular risk in adults, it is unclear whether this index is associated with cardiovascular risk factors in children.

Objective: Our aim was to evaluate the association between increased WC and elevated blood pressure (BP) in children with normal body mass index (BMI) ranges.

Methods: Cross-sectional evaluation of students between 6 and 11 years with normal BMI. WC was categorized by quartile for each age group. Normal BP was defined as values < 90th percentile, and levels above this range were considered elevated. Values of p < 0.05 were considered statistically significant.

Results: Of the 5,037 children initially assessed, 404 (8%) were excluded for being underweight and 1,216 (24.1%) were excluded for being overweight or obese. A final sample of 3,417 children was evaluated. The prevalence of elevated BP was 10.7%. In children with WC in the lowest quartile, the prevalence of elevated BP was 8.1%. This prevalence increased in upper quartiles: 10.6% in the second, 12.4% in third and 12.1% in the upper quartile. So, in this group, being in the highest WC quartile was associated with a 57% higher likelihood to present elevated BP when compared to those in the lowest quartile (Q4 vs Q1; OR 1.57 - 95%CI 1.14 - 2.17).

Conclusion: In children aged 6 to 11 years, increased waist circumference is associated with elevated BP even when BMI is normal.

MeSH terms

  • Blood Pressure
  • Body Mass Index
  • Brazil / epidemiology
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology*
  • Male
  • Obesity, Abdominal / complications*
  • Obesity, Abdominal / epidemiology
  • Pediatric Obesity / complications*
  • Pediatric Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Urban Population
  • Waist Circumference*