Obesity and hypertension

Pediatrics for Parents, Sept, 2003

The incidence of hypertension in children is rising. This may be due to the increase in the number of overweight children.

A study of 2,460 Houston children, 12-16 years old, found a "striking increase" in the number of obese children with hypertension. Only 9% of children classified as normal weight had hypertension. Twenty three percent of the children greater than the 90th percentile for weight had high blood pressure. For children greater than the 95th percentile of weight 34% had hypertension. A total of 23% of the children were obese.

Nearly half the students studied were Hispanic, 36% were African American, 13% were white, and 2% were classified as "other."

"Hispanic and African American students were more obese than white students. And the prevalence of hypertension by ethnicity mirrors this: it was higher in Hispanic and African American students," said Jonathan M. Sorof, MD, the chief researcher in this study.

Dr. Sorof believes that cultural issues play a significant role. "We see many Hispanics in our population, and a healthily built, slightly overweight child is considered beneficial by many parents," he said.

According to Shawna D. Nesbitt, MD, chief of hyperlipidemia and hypertension clinics at the University of Michigan, Ann Arbor, doctors are" ... more successful if (they) don't ask for changes in just one child or adult." Since obesity usually affects more than one person in the family, the chances of a successful weight reduction program increases if the entire family participates in the weight loss effort.

Children with a family history of high blood pressure or diabetes are more likely than children without such a family history to have changes in their blood vessels which are seen in hardening of the arteries. Obese adolescents have an increased risk of dying compared to their non-obese peers, particularly from heart disease.

One concern of parents is that encouraging their children to diet and loose weight will lead to anorexia nervosa, particularly in girls. According to Bonita Falkner, MD, professor of pediatrics at Thomas Jefferson Medical College, Philadelphia, "Anorexia nervosa really stems from psychiatric issues. It's an entirely different category."

Family Practice News, 4/1/03.