High blood pressure screening in children and adolescents from Amargosa, Bahia: usefulness of anthropometric indices of obesity.

Teresa Maria Bianchini De Quadros,Luciana Rodrigues Silva,Jorge Mota,Edmar Lacerda Mendes,Alynne Christian Ribeiro Andaki,Alex Pinheiro Gordia

doi:10.1590/1980-549720190017

Abstract

To determine the predictive power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and their respective cut-off points for high blood pressure (BP) screening in Brazilian children and adolescents. Cross-sectional study conducted with 1,139 students aged 6 to 17years. Body weight, height, WC, and BP were measured. High BP was classified as systolic or diastolic ≥ 95th percentile. Receiver Operating Characteristic (ROC) curves were constructed, and the area under the curve, sensitivity, and specificity were calculated. The prevalence of high BP was 27.0%. Anthropometric indices showed a significant association with high BP (accuracy ranging from 0.62 - 0.81), except for WHtR among male adolescents.Sensitivity was low, regardless of the anthropometric index, gender, and age group. BMI, WC, and WHtR were associated with high BP, but the cut-off points tested showed low sensitivity. Determining specific cut-off points for each population can enable the use of anthropometric indices in high BP screening.

Highlights

High blood pressure (BP) is considered the main individual risk factor for disease burden and overall mortality
body mass index (BMI) and waist circumference (WC) accuracy was significantly greater than waist-to-height ratio (WHtR) (p = 0.001 and p = 0.002, respectively) (Table 2)
Our study revealed a moderate association between WC and high BP – area under the Receiver Operating Characteristic (ROC) curve (AUC) ranging from 0.63 to 0.78

Summary

Introduction

High blood pressure (BP) is considered the main individual risk factor for disease burden and overall mortality. Considering the significant prevalence rates of high BP among children and adolescents[2,3] and the increased risk of this condition persisting in adulthood[4], efforts for early diagnosis and intervention are necessary. The reasons for the under-evaluation of BP are little studied, but could be related to the short duration of pediatric appointments, lack of equipment, especially appropriate cuffs for the arm circumference of young people, and the difficulty in interpreting BP values due to their complex classification criterion – based on percentile distribution according to age, gender, and height[7,8]

Methods

Results

Discussion

Conclusion