Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The correlation of blood pressure with height and weight in Korean adolescents aged 10-19 years; The Korean National Health and Nutrition Examination Surveys (2009-2011)

  • Received : 2013.09.16
  • Accepted : 2013.11.29
  • Published : 2014.01.15
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Abstract

Purpose: Height-specific blood pressure (BP) is the standard parameter used to diagnose childhood hypertension. However, there has been some argument that weight may be a better variable than height in the reference BP standards. Therefore, before assessing the BP status using the reference BP standards, a basic understanding of the fundamental association of weight and height with BP is required. Methods: In the present study, we analyzed the correlation of BP with height and weight in Korean adolescents (age, 10-19 years), using data from the Korean National Health and Nutrition Examination Surveys (2009-2011). Results: Systolic BP (SBP) was more closely correlated with weight than with height in the normal weight (body mass index [BMI], ${\leq}85th$ percentile) and overweight (BMI, >85th percentile) groups and in the normal waist circumference (WC, ${\leq}90th$ percentile) and high WC (>90th percentile) groups in both sexes. Diastolic BP (DBP) had a higher correlation with height than with weight in the normal weight and normal WC groups, whereas weight was more closely associated with DBP than height in the overweight and high WC groups in both boys and girls. Conclusion: In Korean adolescents, weight had a greater effect on SBP than height in both the normal weight and overweight groups. DBP was mainly affected by height in the normal weight group, whereas weight was the major determinant of DBP in the overweight group. Therefore, it may be necessary to consider weight in the establishment of reference BP standards.

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References

  1. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(2 Suppl 4th Report):555-76. https://doi.org/10.1542/peds.114.2.S2.555
  2. Global health risks: mortality and burden of disease attributable to selected major risks [Internet]. Geneva: World Health Organization; c2009 [cited 2013 May 10]. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf.
  3. Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 1995;8:657-65. https://doi.org/10.1016/0895-7061(95)00116-7
  4. Park MK, Menard SW, Schoolfield J. Oscillometric blood pressure standards for children. Pediatr Cardiol 2005;26:601-7. https://doi.org/10.1007/s00246-004-0828-9
  5. Rosner B, Cook N, Portman R, Daniels S, Falkner B. Determination of blood pressure percentiles in normal-weight children: some methodological issues. Am J Epidemiol 2008;167:653-66. https://doi.org/10.1093/aje/kwm348
  6. Korean National Health and Nutrition Examination Survey [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention; c2013 [cited 2013 May 10]. Available from: http://knhanes.cdc.go.kr/.
  7. Korea Centers for Disease Control and Prevention [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention; c2013 [cited 2013 May 10]. Available from: http://www.cdc.go.kr/CDC.
  8. Lauer RM, Burns TL, Clarke WR. Assessing children's blood pressure--considerations of age and body size: the Muscatine Study. Pediatrics 1985;75:1081-90.
  9. Sung RY, Choi KC, So HK, Nelson EA, Li AM, Kwok CW, et al. Oscillometrically measured blood pressure in Hong Kong Chinese children and associations with anthropometric parameters. J Hypertens 2008;26:678-84. https://doi.org/10.1097/HJH.0b013e3282f42270
  10. Taksande A, Chaturvedi P, Vilhekar K, Jain M. Distribution of blood pressure in school going children in rural area of Wardha district, Maharashatra, India. Ann Pediatr Cardiol 2008;1:101-6. https://doi.org/10.4103/0974-2069.43874
  11. Arvedsen SK, Damgaard M, Norsk P. Body height and blood pressure regulation in humans during anti-orthostatic tilting. Am J Physiol Regul Integr Comp Physiol 2012;302:R984-9. https://doi.org/10.1152/ajpregu.00036.2011
  12. Cohen N, Flamenbaum W. Obesity and hypertension. Demonstration of a "floor effect". Am J Med 1986;80:177-81. https://doi.org/10.1016/0002-9343(86)90006-9
  13. Guyton AC. The surprising kidney-fluid mechanism for pressure control: its infinite gain! Hypertension 1990;16:725-30. https://doi.org/10.1161/01.HYP.16.6.725
  14. Hall JE. Mechanisms of abnormal renal sodium handling in obesity hypertension. Am J Hypertens 1997;10(5 Pt 2):49S-55S..
  15. Grassi G, Seravalle G, Cattaneo BM, Bolla GB, Lanfranchi A, Colombo M, et al. Sympathetic activation in obese normotensive subjects. Hypertension 1995;25(4 Pt 1):560-3. https://doi.org/10.1161/01.HYP.25.4.560
  16. Landsberg L, Krieger DR. Obesity, metabolism, and the sympathetic nervous system. Am J Hypertens 1989;2(3 Pt 2):125S-132S. https://doi.org/10.1093/ajh/2.3.125S
  17. Rocchini AP, Yang JQ, Gokee A. Hypertension and insulin resistance are not directly related in obese dogs. Hypertension 2004;43:1011-6. https://doi.org/10.1161/01.HYP.0000123073.48855.e9
  18. Ruano M, Silvestre V, Castro R, Garcia-Lescun MC, Rodriguez A, Marco A, et al. Morbid obesity, hypertensive disease and the renin-angiotensin-aldosterone axis. Obes Surg 2005;15:670-6. https://doi.org/10.1381/0960892053923734
  19. Gudbjornsdottir S, Elam M, Sellgren J, Anderson EA. Insulin increases forearm vascular resistance in obese, insulin-resistant hypertensives. J Hypertens 1996;14:91-7.
  20. Hall JE, Brands MW, Zappe DH, Dixon WN, Mizelle HL, Reinhart GA, et al. Hemodynamic and renal responses to chronic hyperinsulinemia in obese, insulin-resistant dogs. Hypertension 1995; 25:994-1002. https://doi.org/10.1161/01.HYP.25.5.994
  21. Mark AL, Shaffer RA, Correia ML, Morgan DA, Sigmund CD, Haynes WG. Contrasting blood pressure effects of obesity in leptin-deficient ob/ob mice and agouti yellow obese mice. J Hypertens 1999;17(12 Pt 2):1949-53. https://doi.org/10.1097/00004872-199917121-00026
  22. Lundberg JM, Pernow J, Franco-Cereceda A, Rudehill A. Effects of antihypertensive drugs on sympathetic vascular control in relation to neuropeptide Y. J Cardiovasc Pharmacol 1987;10 Suppl 12:S51-68.
  23. Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE, et al. Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 2001;86:1930-5. https://doi.org/10.1210/jcem.86.5.7463

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