BackgroundChildhood and adolescent obesity present a global health concern, notably due to its association with adverse outcomes such as high blood pressure (HBP). Waist circumference (WC) and waist-to-height ratio (WHtR) are promising indicators for assessing HBP risk in school-age adolescents. However, their association with Stavnsbo-recommended WC cutoff points and high BP prevalence necessitates further investigation, holding potential implications for early intervention and prevention strategies. ObjectiveInvestigate the association between high blood pressure (HBP) and WC cutoff points advised by Stavnsbo, along with WHtR, in adolescents from privileged socioeconomic backgrounds in Brazil. MethodsThis cross-sectional study in 2022 involved 216 students aged 9 to 16 from a private school in Londrina, Paraná, Brazil. Data, collected through an internal project monitoring anthropometric and social indicators, included validated blood pressure assessments. Statistical analyses, employing t-tests, chi-square tests, and logistic regression, explored relationships between WC, WHtR, and blood pressure, adjusting for covariates. ResultsFemale participants had a lower prevalence of obesity (2.9% vs 5.3%) but a higher prevalence of overweight (27.5% vs 17.5%) compared to males. The overall excess weight prevalence was 26.4%, with females showing lower absolute risk scores for WC (25.5% vs 34.2%), WHtR (19.6% vs 23.7%), and HBP (21.5% vs. 40.3%). Significant associations were observed between HBP and WC (X2=9.759, P=0.002) as well as WHtR (X2=6.335, P=0.012) among males, with those in the "Risk" category exhibiting higher HBP prevalence. Overall, both WC and WHtR demonstrated significant associations with HBP (X2=12.428, P<0.001, and X2=9.550, P=0.002, respectively). Logistic regression indicated higher odds for HBP in males with risk values for WC (OR 3.876 [1.714-8.765 CI], P=0.001) or WHtR (OR 3.684 [1.457-9.315 CI], P=0.006). In the overall analysis, participants with risk values for WC had 3.2 (1.688-6.080 CI, P<0.001) times higher odds, and for WHtR, 3.4 (1.679-6.934 CI, P=0.001) times higher odds of HBP. ConclusionThis study highlights the associations between WC, WHtR, and HBP in adolescent schoolchildren. The results underscore the significance of gender-specific assessments and emphasize the potential of these anthropometric measures as valuable tools for identifying and managing HBP risk in adolescents. Further research and clinical applications are imperative to deepen understanding and address the health needs of this vulnerable population.