Evaluation of Hypertension and Pre-Hypertension among Obese Children Living in Saudi Arabia by National and International Guidelines of Hypertension

Abstract

Background: Pediatrics hypertension is a major public health concern. The burden of hypertension among children has increased especially in high-income countries due to the surge in obesity prevalence. Objective: The current study aimed to evaluate the differences and similarities in the prevalence of hypertension and prehypertension among obese students living in Jeddah estimated by the updated Saudi guidelines and the guidelines of American Academy of Pediatrics for hypertension. Patients and Methods: This cross-sectional study included a total of 107 students having BMI >18.5 and 192 students having BMI <18.5, served as a control, matched in age and gender. They were collected from national and international schools and from out-patient clinics of Hospitals of Ministry of Health . This study was done between October 2019 and March 2020. The participants were subjected to blood pressure measurements, classified based on updated Saudi & American guidelines of hypertension 2017. Results: Among overweight/obese students’ systolic hypertension was significantly higher and was 2.344 more likely to occur than among normal students (95% CI:1.283 – 4.285. <0.001), the prevalence of systolic hypertension grade I was significantly higher by Saudi guidelines compared to that recorded by American among overweight/obese group (21.5% versus 12.1, P=0.004). The prevalence of elevated systolic blood pressure by American guidelines was significantly higher among overweight/obese group above 13 year when compared to its similar by Saudi guidelines (37.4% versus 25.2%, P=0.004). Conclusion: It could be concluded that overweight/obese students are at least two times more susceptible for hypertension than normal body weight students. A fixed threshold for hypertension of the updated American guidelines for teenager could be the cause of a down-estimation of prevalence of hypertension to prehypertension state.