Elevated blood pressure in children with cerebral palsy and its relationship with adiposity and physical activity

Abstract

BackgroundThere is a high prevalance of hypertension in adults with with cerebral palsy (CP). However, less is known about blood pressure in children with CP. ObjectiveThe aim was to determine if blood pressure is elevated in children with CP and whether it is related to adiposity and physical activity. MethodsThirty children with spastic CP (5–11 y) and 30 age-, sex-, and race-matched typically developing control children were studied. Resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured, and mean arterial pressure (MAP) was calculated. Visceral fat mass and total body fat mass index (FMI) were determined using dual-energy X-ray absorptiometry. Physical activity was assessed using accelerometer-based monitors. ResultsChildren with CP had higher DBP and heart rate than controls (p < 0.05). DBP percentile and MAP were also higher in children with CP when BMI was statistically controlled. Children with CP and elevated blood pressure or hypertension (n = 8) had 56% more visceral fat mass than children with CP and normal blood pressure (n = 22; p < 0.05). In the groups combined, blood pressure was directly related to visceral fat mass and FMI, and inversely related to physical activity (p < 0.05). However, in children with CP alone, only visceral fat mass was related to blood pressure (p < 0.05). ConclusionsChildren with CP have higher resting blood pressure than typically developing children. The higher blood pressure is related to higher visceral adiposity. Careful blood pressure screening should start during childhood in individuals with CP.