Association of joint effect of overweight/obesity and elevated blood pressure with left ventricular hypertrophy in children

Abstract

Objective: To examine the association of joint effect of overweight (including obesity) and elevated blood pressure (BP) with left ventricular hypertrophy (LVH) in children. Methods: A convenient cluster sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 319 children aged 6-11 years old who had complete data on anthropometric indices and variables collected using a questionnaire were included in the study. LVH was defined as left ventricular mass index (LVMI) ≥90 th percentile for sex and age of this population. Based on weight status (yes vs. no) and elevated BP status (yes vs. no), all participants were divided into four subgroups (normal weight and normal BP, normal weight and elevated BP, overweight and normal BP, overweight and elevated BP). LVMI levels or prevalence of LVH across four subgroups were compared. The multivariate logistic regression model was used to examine the association of joint effect between overweight and elevated BP with LVH in children. Results: The age of children was (8.4±1.6) years, and boys accounted for 53.3% (n=703). There were significant differences in LVMI levels and prevalence of LVH across four subgroups (P<0.05); Children with both overweight and elevated BP (n=184) had the highest LVMI levels and prevalence of LVH [LVMI: (30.69±0.32) g/m(2.7); the prevalence of LVH: 24.46%]. After the adjustment for potential covariates, compared to children with both normal weight and normal BP (n=657), the risk of LVH in children with elevated BP alone (n=136) was not increased [OR (95%CI) was 0.89 (0.30-2.62)]. Children with overweight alone (n=342) [OR (95%CI) was 5.69(3.39-9.55)] and those with both overweight and elevated BP [OR (95%CI) was 9.45 (5.47-16.33)] were at higher risk of LVH. Conclusion: The joint effect between overweight and elevated BP could be highly correlated with LVH in children.