Prehypertension in outpatient obese children

Abstract

Background The aim of the study was to analyze the prevalence of prehypertension (PH) in obese (OB) children and its relation with estimated glomerular filtration rate (eGFR) and left ventricular (LV) function.MethodsThe study included 447 OB and 131 normal-weight children. PH was defined according to the criteria proposed by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Insulin sensitivity was evaluated by HOMA IR, and eGFR was calculated by Schwartz's formula. LV function was analyzed by echocardiography in 165 OB children.ResultsPH was observed in 79 OB children (17.7%) and in 2 (1.5%) controls. Among OB children, those with PH had greater percentage of males (P 0.05), higher level of body mass index (BMI) (P 0.001), waist circumference (WC) (P 0.005), and HOMA IR (P 0.001), compared to PH children. The two groups did not differ for eGFR and LV function. At logistic regression analysis, PH was independently associated with male gender (P 0.025) and HOMA IR (P 0.002). Gender analysis showed that boys with PH presented higher levels of BMI (P 0.005), WC (P 0.01), HOMA IR (P 0.001), and triglycerides (P 0.005) compared to PH boys. Females with PH were older and in more advanced postpubertal stage, had higher BMI, WC (P 0.05, for all), and HOMA IR (P 0.025), compared to PH girls.ConclusionsIn a population of outpatient OB children, the prevalence of PH was 17.7% and boys were more likely than girls to have PH. This condition is characterized by insulin resistance in both sexes but no impairment in glomerular and LV function. © 2009 American Journal of Hypertension, Ltd.