The Relationship Between Obesity and Hypertension in Adolescents

The increasing prevalence of central obesity in adolescents is accompanied by an increase in risk factors for cardiovascular disease. The study aims to analyze the relationship between central obesity and the risk of hypertension in obese adolescents, including both male and female subjects. This study was undertaken to provide opportunities for further exploration of the relationship between central obesity and hypertension in adolescents. The study was a retrospective observational study that utilized medical record data from a previous research project entitled "Polimorfisme Gen Adiponectin ADIPOQ +45 T>G, ADIPOQ – 11377 C>G dengan Kadar Adiponektin Pada Remaja Obesitas dan Resiko Sindrom Metabolik." This data was obtained from research conducted on obese adolescents aged 13-18 years in junior and senior high schools in Surabaya and Sidoarjo who met the criteria. The sample comprised 140 obese adolescents, who were then categorized into two groups: those without central obesity and those with central obesity. Statistical data were analyzed using SPSS with the Chi Square test. There is a very strong and significant relationship between central obesity and the risk of hypertension in obese adolescents (p = 0.000; r = 0.373); central obesity and the risk of hypertension in obese male adolescents (p = 0.001; r = 0.587); and central obesity and the risk of hypertension in obese female adolescents (p = 0.003; r = 0.300). The study found a significant relationship between central obesity and hypertension risk in obese adolescents. Adolescents with central obesity were 3.6 times more likely to develop hypertension than those without. Male adolescents with central obesity were 6.5 times more likely to develop hypertension than those without. Female adolescents with central obesity were 2.9 times more likely to develop hypertension

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure.
 Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents.
 Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure.
 Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure.
 Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure.

Background : Hypertension in children and adolescents can be defined as Systolic Blood Pressure (TDS) / Diastolic Blood Pressure (TDD) on repeated measurements obtained from values above 95 percentiles. The incidence of hypertension in Riskesdas 2013 data for the age group 15-17 years is 5.3%. The prevalence of hypertension in adolescents in the province of Central Java in the 2013 Riskesdas data was 12.8%. Prevention of increasing the value of hypertension prevalence in adolescents can be done with aerobic exercise activities such as jogging. Objective: To determine the effect of giving aerobic exercise activities to changes in blood pressure in adolescents with hypertension. Method: Thistype of research is experimental with Randomized Control Trial Group Design. Sampling was done randomly to get 18 treatment subjects and 18 control subjects. Data collected were age, sex, weight, height, sodium intake, level of physical activity, blood pressure before and after treatment. Test the independent t-test wasused for data differences in blood pressure before and after treatment in both groups and paired t-test to determine changes in blood pressure before and after treatment, whereas the test ANOVA repeated measured is used to determine the effect of aerobic exercise (jogging)on blood pressure sample. Results: There were differences in systolic and diastolic blood pressure between the treatment and control groups (p 0.05). There is an effect of giving aerobic exercise activities to decrease systolic and diastolic blood pressure (p = 0,000 and p = 0.003) for each measurement at each meeting. Conclusion: The provision of aerobic exercise activities affects the decrease in diastolic systolic blood pressure in adolescents with hypertension.

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This paper reviewed the available research literature to determine the role of exercise training in reducing resting blood pressure in adolescents. Similar to the adult population, there is little evidence to support the efficacy of exercise training for reducing resting blood pressure in normotensive adolescents, although several studies reported small decreases in either or both systolic and diastolic pressure. In hypertensive adolescents, aerobic-type exercise training consistently reduced both systolic and diastolic pressure, but seldom to completely normal levels. Resistance training has not been studied as extensively, but may be of some benefit. It is recommended that chronic aerobic and strength activities be part of an overall health maintenance program.

Background Increasing prevalence of pediatric obesity and hypertension demonstrate the urgent need for early intervention. Waist circumference (WC) provides a measurement of central obesity, which has been specifically associated with cardiovascular risk factor including hypertension.Objectives To identify the optimal cut􀀹off point of we in predicting hypertension in obese adolescents.Methods We randomly recruited 115 adolescents aged 12-17 years from schools in Yogyakarta, Central Java, Indonesia. We measured height, weight, WC, and blood pressure in 109 subjects. Optimum WC cut-offs to predict hypertension were determined using receiver-operating characteristic (ROC).Results The optimum WC cut off point to predict any hypertension in adolescents was at the 88.95 cm with 97.8% sensitivity and 47.3% specificity. Age􀀹specific cut􀀹off points for subjects < 15 year old was 90.1 cm with 91.7% sensitivity and 58%specificity, and for subjects 2: 15 year old was 103.5 cm with 75% sensitivity and 88% specificity.Conclusions Waist circumference can be used to predict hypertension in obese adolescents with fair sensitivity and specificity. Waist circumference values associated with hypertension in adolescents vary with age and ethnicity.

Largely due to the childhood obesity epidemic, there has been an increase in the prevalence of hypertension in children and adolescents. Obesity associated hypertension is the most common hypertension phenotype among adolescents. Approximately 30% of obese adolescents have elevated blood pressure (BP) or hypertension. Updated definitions of elevated BP and hypertension in adolescents are now similar to definitions of BP status in adults. For adolescents ≥13 years of age, elevated BP is 120 to 129/<80 mm Hg. Hypertension, stage 1, is ≥130 to 139/80 to 89 mm Hg, and hypertension, stage 2, is ≥140/90 mm Hg. BP measurements over separate clinic visits are necessary to verify the diagnosis of elevated BP or hypertension. Ambulatory BP monitoring, when available, provides confirmatory data on BP status. Causal mechanisms for obesity associated hypertension include increased sympathetic nervous system activity, increased renal sodium retention secondary to insulin resistance/hyperinsulinemia, and obesity mediated inflammation. The primary treatment for obesity associated hypertension is weight reduction with lifestyle changes in diet and physical activity. Although difficult to achieve, even modest weight reduction can be beneficial. The diet should be rich in fruits, vegetables, fiber, and low-fat dairy with reduction in salt intake. When lifestyle changes are insufficient to achieve BP control, pharmacologic therapy is indicated to achieve a goal BP of <130/80 mm Hg or <90th percentile, whichever is lower. Regular BP monitoring is necessary for ongoing management of obesity associated hypertension in adolescents.

Hypertension in children and adolescents is under-recognized and under-diagnosed in clinical practice. The 2017 AAP Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents provides updated recommendations that may improve hypertension identification and management. The AAP blood pressure guideline recommends annual screening for hypertension in children at preventive care visits and targeted routine screening in high-risk populations. A simplified blood pressure screening table is provided for easier recognition of blood pressures that may require attention. Normative blood pressure tables have been revised to include only data from normal-weight children as more representative of a healthy population. Classification of blood pressure in adolescents has been simplified to threshold values consistent with adult guidelines. The updated AAP blood pressure guideline has clarified and simplified recommendations for hypertension screening, diagnosis, and management based on a systematic review of current best evidence.

Turning Attention to the Young

Background and purpose: There are indications that the prevalence of obesity among adolescents is increasing which is one of the main factors of hypertension. This study aims to determine the association between hypertension among obese adolescents with physical activity, fiber and salt intake. Methods: This study used a cross-sectional design among obese adolescents aged 12-15 years. The study was conducted at six public/ private middle schools in the North Denpasar Sub-district, Denpasar City, Bali Province. The samples of 203 children were selected from the results of obesity screening conducted by North Denpasar III Public Health Center (PHC). Data collection was conducted over July-September 2018 with data included social demographics, body weight and height, blood pressure, consumption frequency of vegetables, fruits and high salt content foods, and physical activity carried out in the past week. Data analysis with logistic regression was conducted to determine the association between physical activity, fiber and salt intake with hypertension among obeseadolescents. Results: This study found that of 203 respondents, 14.8% had hypertension. Multivariate analysis showed that hypertension in obese adolescents was associated with salt intake ≥1500 mg/day with adjusted odd ratio (AOR) of 5.19 (95%CI: 2.20-12.22), inadequate physical activity (AOR=5.87; 95%CI: 1.19-29.00) and inadequate fiber intake (AOR=2.43; 95%CI: 0.27-21.76). Conclusion: Salt intake ≥1500 mg/day and inadequate physical activity are associated with hypertension among obese adolescents. A reduction in the consumption of processed foods that are high in salt and increasing physical activity would improve adolescent health.

Background and purpose: There are indications that the prevalence of obesity among adolescents is increasing which is one of the main factors of hypertension. This study aims to determine the association between hypertension among obese adolescents with physical activity, fiber and salt intake.Methods: This study used a cross-sectional design among obese adolescents aged 12-15 years. The study was conducted at 6 public/private middle schools in the North Denpasar Sub-district, Denpasar City, Bali Province. The samples of 203 children were selected from the results of obesity screening conducted by North Denpasar III Public Health Center (PHC). Data collection was conducted over July-September 2018 with data included social demographics, body weight and height, blood pressure, consumption frequency of vegetables, fruits and high salt content foods, and physical activity carried out in the past week. Data analysis with logistic regression was conducted to determine the association between physical activity, fiber and salt intake with hypertension among obese adolescents.Results: This study found that of 203 respondents,14.8% had hypertension. Multivariate analysis showed that hypertension in obese adolescents was associated with salt intake ≥1500 mg/day with adjusted odd ratio (AOR) of 5.19 (95%CI: 2.20-12.22), inadequate physical activity (AOR=5.87; 95%CI: 1.19-29.00) and inadequate fiber intake (AOR=2.43; 95%CI: 0.27-21.76).Conclusion: Salt intake ≥1500 mg/day and inadequate physical activity are associated with hypertension among obese adolescents. A reduction in the consumption of processed foods that are high in salt and increasing physical activity would improve adolescent health.

Prevalence of hypertension in adolescents has increased worldwide and is considered a risk factor for hypertension and cardiovascular disease in adulthood. Although obesity and sleep deficiency increase this risk, the combined effects of these factors on hypertension remain unclear. This study aimed to examine the combined effects of obesity and sleep duration on hypertension in adolescents. This study was conducted using data from the 2016 to 2018 Korean National Health and Nutrition Examination Survey, which included a study population of 1272 adolescents. The participants were categorized into four groups based on sleep duration and body mass index (BMI) percentiles: normal sleep and normal body mass group (reference; normal), only short sleep group (short sleep), only overweight/obesity group (overweight/obesity), and short sleep and overweight/obesity group (short sleep and overweight/obesity). Short sleep duration was defined as <8 h of average sleep duration, and overweight/obesity was defined as a BMI ≥ 85th percentile. Hypertension in adolescents was defined as a systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. The prevalence of hypertension was 9.2% among Korean adolescents. Short sleep duration with overweight/obesity were associated with a significantly increased risk of hypertension (odds ratio = 6.57; 95% confidence interval: 3.27-13.20) in adolescents, and controlling for the potential confounding variables only partially attenuated this relationship (odds ratio = 5.28; 95% confidence interval: 2.28-12.26). This study demonstrated that the coexistence of short sleep duration and obesity was associated with an increased risk of hypertension in Korean adolescents.

The number of visits and blood pressure measurements influence the prevalence of high blood pressure in adolescents

The prevalence of hypertension in adolescents in Indonesia shows a very rapid increase. This is a common blood pressure problem. This can be caused by unhealthy eating patterns and lack of exercise. This study aims to determine the relationship between diet and physical activity levels with blood pressure in adolescents. This research uses a correlational analytical research design with a cross sectional approach. The sample in this study was 116 students in grades 10, 11 and 12 of SMAN 2 Dumai City. The collected data was analyzed univariately and bivariately using the chi square test. The results of univariate analysis showed that the majority of respondents were in their middle teens, 83 people (71.6%), 80 people (69.0%) were female, 114 people (98.3%) did not smoke, 79 people (68%) had normal systolic blood pressure. .1%), normal diastolic blood pressure in 81 people (69.8%), good diet in 80 people (69.0%), and heavy physical activity in 90 people (77.6%). Based on the results of the chi square test, significant values were obtained for the systolic diet variable with a value of ρ 0.000 α 0.05, and the diastolic diet variable with a value of ρ 0.000 α 0.05 and the systolic physical activity variable with a value of ρ 0.204 α 0.05 and physical activity in diastole with a value of ρ 0.231 α 0.05. It can be concluded that there is a relationship between diet and blood pressure in adolescents, and there is no relationship between physical activity and hypertension blood pressure in adolescents.

Background: The prevalence of essential hypertension in children and adolescents has increased dramatically over the past decade attributed to a rising prevalence of obesity, high salt diet and lack of exercise. Traditionally high blood pressure in adolescents required extensive work up to determine a cause, but given the changing demographics this policy needs to be reviewed. Objectives/method: The study aimed describe the risk factors, demographics, target organ damage and aetiology of hypertension in a cohort of young hypertensives (aged 15 - 30 years) referred to a tertiary hypertension clinic at Groote Schuur Hospital, by retrospectively reviewing the folders over a three-month period. Results: Thirty eight patients were identified with a mean age of 22 years. Essential hypertension was diagnosed in 82% of patients, and 71% of patients had a family history of hypertension. The median systolic blood pressure (BP) at first visit was 132 mmHg and diastolic BP 84mmHg. The median BMI was 25.4 kg/m2 and 68% had some form of target organ damage. Twenty six percent were current smokers and 8% had abused metamphetamines. Recognised secondary causes of hypertension were renal artery stenosis (four) and primary aldosteronism (one). Conclusions: In a cohort of young hypertensives patients the dominant cause was essential hypertension. Although the prevalence of obesity was surprisingly low compared to previously published studies, significant lifestyle issues were identified. 68% had target organ damage suggesting the disease was not benign. These preliminary results indicate that larger cohorts need to be studied to develop new policies for assessment and treatment of young people with hypertension in South Africa.