Background: Pediatric hypertension is more likely to develop in overweight and obese subjects.
Purpose: To assess the prevalence of overweight and other anthropometric and laboratory cardiovascular disease (CVD) risk factors among 3–18 years old subjects participating in the PEP Family Heart Study Nuremberg
Methods: Using LMS 2.1 and SPSS 21 we calculated in 7,076 children and adolescents the age-, gender- and height-adjusted percentiles (and cut-offs) for eight risk variables: overweight (85–95thpctl) abdominal adiposity (waist circumference ≥90thpctl), Non HDL-C (≥95thpctl), Triglycerides (TG≥95thpctl), High Density Cholesterol (HDL-C <5thpctl), TG/HDL-C-Ratio (>90th), LDL- C (≥95thpctl), and fasting plasma glucose (FPG) >95thpctl. Hypertension was defined as SBP and/or DBP ≥95thpctl.
Results: In 361 hypertensive males/females the prevalence was higher than in 6,707 normotensive males/females for overweight (12.8/22.4% vs. 9 9/8.6%), obesity (17.3/24.2% vs. 4.8/3.6%) and abdominal adiposity (22.4/33.9% vs. 10.0/9.2). The effect of relative adiposity on BP was minimal until the beginning of the overweight category at the 85th percentile of BMI, at which point BP steeply increased in both genders. The prevalence of abnormal laboratory risk variables was not much different between hypertensive and normotensive males/females for increased FPG (7.7/10.3% vs. 9.1/6.8%), Non HDL-C 21.4/26.1% vs. 20.6/21.8%, TG 1.5/6.1% vs. TG 1.4/2.2%, low HDL-C 2.1/3.6% vs. 2.1/2.6% except the TG/HDL-C ratio 17.9/1.8% vs. 11.2/14.3. The significant age- and gender adjusted associations between children and adolescents with and without hypertension were OR 1.5 (95% CI 1.2–2,0) for the increased TG/HDL-C ratio ≥2.27 suggesting insulin resistance, for overweight OR 2.1 (95% CI 1.6–2.8) and for abdominal adiposity OR 3.6 (95% CI 2.8–4.6). Whereas 91.4% of normotensive males and 91.1% of normotensive females had less than one risk factor 86.1% of the hypertensive males and 76.1% of the hypertensive females had less than one additional risk factor.
Conclusions: Hypertensive children and adolescents who participated in the PEP Family Heart Study Nuremberg had a 2.1 times higher risk for overweight, a 3.6 fold higher risk for abdominal adiposity and were at a 1.5 times higher risk of being insulin resistant,