Background The increasing hypertension (HTN) prevalence in children, largely driven by obesity, highlights the need to investigate its risk factors, including the role of abdominal obesity. Methods We analysed data from the Korea National Health and Nutrition Examination Survey (2007–2021) to assess the prevalence of overweight and obesity (OW-OB), elevated blood pressure (EBP), and HTN among 11,554 participants aged 10–18 years. EBP and HTN were defined according to the 2017 American Academy of Pediatrics guidelines, and abdominal obesity was defined as a waist-to-height ratio (WHtR) of ≥ 0.5. Secular trends in the prevalence of OW-OB and EBP-HTN were examined across five time periods, and risk factors for EBP-HTN were evaluated in OW-OB children stratified by abdominal obesity status. Results The prevalence of EBP, HTN, and OW-OB was 8.22% (95% confidence interval [CI], 7.60–8.86), 10.46% (95% CI, 9.72–11.20), and 25.11% (95% CI, 24.17–26.05), respectively. Among the 3,015 participants with OW-OB, 13.53% (95% CI, 12.03–15.04) and 17.64% (95% CI, 15.98–19.31) were diagnosed with EBP and HTN, respectively. Although the prevalence of OW-OB and EBP-HTN had increasing trends from 2007 to 2009 to 2019–2021, these trends were not statistically significant. In the children with OW-OB, obesity severity, male sex, older age, and paternal HTN were associated with EBP-HTN. The HTN risk factors differed according to abdominal obesity status. In participants with abdominal obesity, male sex (OR 2.32, 95% CI 1.643–3.299; p < 0.0001), older age (OR 1.16, 95% CI 1.102–1.233; p < 0.0001), and severe obesity (OR 3.12, 95% CI 1.991–4.895; p < 0.0001) were significant risk factors; whereas, in those without abdominal obesity, paternal HTN (OR 1.66, 95% CI 1.207–2.303; p = 0.0025), hypercholesterolemia (OR 1.85, 95% CI 1.114–3.083; p = 0.0178), male sex (OR 1.83, 95% CI 1.329–2.530; p = 0.0002), and older age (OR 1.11, 95% CI 1.036–1.198; p = 0.0038) were significant risk factors. Conclusions In children with overweight or obesity, the risk factors for EBP-HTN vary depending on the presence of abdominal obesity. These findings highlight the need for differentiated surveillance and prevention strategies based on abdominal obesity status in this high-risk population. Clinical trial number Not applicable

Different risk factors for elevated blood pressure according to abdominal obesity in overweight children and adolescents

期刊论文
出版模式：

开放获取
发表日期：

2025年4月4日

查看全文

Soo In Jeong,
Hae-Rim Kim,
Sung Hye Kim

摘要

Background

The increasing hypertension (HTN) prevalence in children, largely driven by obesity, highlights the need to investigate its risk factors, including the role of abdominal obesity.

Methods

We analysed data from the Korea National Health and Nutrition Examination Survey (2007–2021) to assess the prevalence of overweight and obesity (OW-OB), elevated blood pressure (EBP), and HTN among 11,554 participants aged 10–18 years. EBP and HTN were defined according to the 2017 American Academy of Pediatrics guidelines, and abdominal obesity was defined as a waist-to-height ratio (WHtR) of ≥ 0.5. Secular trends in the prevalence of OW-OB and EBP-HTN were examined across five time periods, and risk factors for EBP-HTN were evaluated in OW-OB children stratified by abdominal obesity status.

Results

The prevalence of EBP, HTN, and OW-OB was 8.22% (95% confidence interval [CI], 7.60–8.86), 10.46% (95% CI, 9.72–11.20), and 25.11% (95% CI, 24.17–26.05), respectively. Among the 3,015 participants with OW-OB, 13.53% (95% CI, 12.03–15.04) and 17.64% (95% CI, 15.98–19.31) were diagnosed with EBP and HTN, respectively. Although the prevalence of OW-OB and EBP-HTN had increasing trends from 2007 to 2009 to 2019–2021, these trends were not statistically significant. In the children with OW-OB, obesity severity, male sex, older age, and paternal HTN were associated with EBP-HTN. The HTN risk factors differed according to abdominal obesity status. In participants with abdominal obesity, male sex (OR 2.32, 95% CI 1.643–3.299; p < 0.0001), older age (OR 1.16, 95% CI 1.102–1.233; p < 0.0001), and severe obesity (OR 3.12, 95% CI 1.991–4.895; p < 0.0001) were significant risk factors; whereas, in those without abdominal obesity, paternal HTN (OR 1.66, 95% CI 1.207–2.303; p = 0.0025), hypercholesterolemia (OR 1.85, 95% CI 1.114–3.083; p = 0.0178), male sex (OR 1.83, 95% CI 1.329–2.530; p = 0.0002), and older age (OR 1.11, 95% CI 1.036–1.198; p = 0.0038) were significant risk factors.

Conclusions

In children with overweight or obesity, the risk factors for EBP-HTN vary depending on the presence of abdominal obesity. These findings highlight the need for differentiated surveillance and prevention strategies based on abdominal obesity status in this high-risk population.

Clinical trial number

Not applicable