Obesity indices as predictive factors for paediatric hypertension: A population-based study in Bali, Indonesia

Abstract

Introduction: Growing recognition of coexisting obesity and hypertension epidemics in children and adolescents could prevent it from being an insurmountable burden following its trajectory into adulthood. Objectives: To determine the predictive ability of obesity indices for paediatric hypertension. Method: In this retrospective cross-sectional study, a multi-stage sampling method was employed to recruit proportional population-based samples across Bali, Indonesia. A total of 436 students aged 6-17 years who had no prior history of hypertension / prolonged use of drugs affecting blood pressure were included in the analysis. Nutritional status assessment warranted a two-step assessment using weight-for-height and body mass index (BMI)-forage CDC 2000 charts for each gender. Bivariate and multivariate analyses were done to find associated factors. Receiver operating characteristic (ROC) curve analysis was done to assess the predictive ability of waist circumference. Results: In this study there were 229 children with hypertension. The prevalence of overweight (14.7%) and obesity (40.8%) in hypertensive students was greater than the overall overweight (13.1%) and obesity (32.8%) prevalence. Age, nutritional status and waist circumference were significantly increased in the group with hypertension on bivariate analysis. After multivariate analysis, increasing age (prevalence ratio [PR] 1.106; 95%CI 1.015-1.205) and obesity (PR 2.174; 95%CI 1.371-3.445) were significantly associated with hypertension but not waist circumference. Optimal cut-off points for male (65.5 cm) and female (62.5 cm) waist circumference were obtained. Conclusions: Obesity status and waist circumference served as promising predictors of hypertension.