scholarly journals Waist-to-height ratio and skipping breakfast are predictive factors for high blood pressure in adolescents

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
C. Aparicio-Cercós ◽  
M. Alacreu ◽  
L. Salar ◽  
L. Moreno Royo

Abstract The purpose of this study was to estimate the prevalence of high blood pressure (HBP) in adolescents of the Valencian Autonomous Community (VC) in Spain. Besides, its association with other risk factors related to cardiovascular disease (CVD) or arterial hypertension (AHT) in order to increase our knowledge of public health and to provide advice about healthy diets. We conducted a multicentre, observational, cross-sectional, epidemiological study in a sample of 4402 adolescents from 15 schools during the 2015–2016 school year. The participants were aged between 11 and 18 years, and any individuals already diagnosed with AHT were excluded. In addition to the Physical Activity Questionnaire for Adolescents (PAQ-A), Evaluation of the Mediterranean Diet Quality Index (KIDMED), a lifestyle habits survey, the waist-to-height ratio (WtHR), and body mass index (BMI) were calculated for each participant. Informed Consent was obtained from Parents of the adolescents involved in the current study. The study received approval from the University ethics committee and all procedures were conducted in accordance with the tenets of the Declaration of Helsinki. Chi-squared, Student t-tests, and ANOVA statistical analyses showed that 653 (14.8%) adolescents had previously undiagnosed HBP and that was significantly associated with male sex (p < 0.001), age over 15 years (p < 0.05), and height, weight, waist circumference, WtHR, BMI, and skipping breakfast. Based on the data we obtained in this study, the modifiable factors that influence HBP in adolescents were WtHR, BMI, and skipping breakfast.

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032874 ◽  
Author(s):  
Joyce Ying Hui Tee ◽  
Wan Ying Gan ◽  
Poh Ying Lim

ObjectiveTo compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds.DesignCross-sectional study.SettingProbability proportionate to size was used to randomly select two schools in Selangor state, Malaysia.ParticipantsA total of 513 adolescents (58.9% women and 41.1% men) aged 12–16 years were recruited.Primary and secondary outcome measuresWeight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve.ResultsBMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes.ConclusionsThese findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.


2015 ◽  
Vol 24 (1) ◽  
pp. 30-5 ◽  
Author(s):  
Kurnia Febriana ◽  
Neti Nurani ◽  
Madarina Julia

Background: Obesity is associated with increased risk for high blood pressure (BP). Although a routine BP measurement is indicated for all children visiting pediatric practice, recognition of children particularly at risk may save times. The aim of this study was to assess the cut-off point for body mass index (BMI) and waist-to-height ratio (WHtR) to predict high BP in adolescents. Methods: We conducted a cross-sectional study on 928 children aged 11 to 16 years in Yogyakarta. BP were measured using standard technique described by The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. BMI was adjusted for age and sex using the WHO 2007 growth reference. WHtR was ratio of waist circumference related to height in centimeters. Receiver operating characteristic (ROC) curves were used to estimate the best cut-offs. Results: The best cut-off point for BMI-for-age Z-score (BMIZ) to predict high BP was 0.51 with sensitivity and specificity of 82% (95% CI = 78-86) and 76% (95% CI = 67-78) for systolic BP and sensitivity and specificity of 82% (95% CI = 78-86) and 72% (95% CI = 68-76) for diastolic BP. The best cut-off point for WHtR was 0.45, with sensitivity of 76% (95% CI = 67-78) and specificity of 74% (95% CI = 71-79) for systolic BP and sensitivity of 76% (95% CI = 72-80) and specificity of 70% (95% CI = 61-75) for diastolic BP.Conclusion: BMIZ of 0.51 and WHtR of 0.45 are the best cut-off point to predict high BP in adolescents.


2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
A Kerimkulova ◽  
A S Ospanova ◽  
R G Nurpeissova ◽  
G M Kamalbekova ◽  
T H Rymbaeva

Abstract Introduction The obesity and overweight epidemic, together with increasing cardiovascular disease, represent a major health problem worldwide, and their occurrence in childhood and adolescence has increased in recent time. Purpose to assess the association of  waist circumference (WC) and waist-to-height ratio (WHtR) coefficient with occurrence rate in adolescents with high blood pressure. Materials and methods The results of a single-step cross-sectional study of teenagers aged 12-13 years studied in 12 secondary schools in our city (Kazakhstan) are presented. The study included adolescents in the amount of 1519 (average age, standard deviation 12.3 + 0.46 years). For representing the outcomes there were used  the measurement of weight, height, BMI, WC, WHtR and the blood pressure of adolescents. Criteria for BP: normal BP (SBP and DBP &lt;89th percentile); high normal BP (SBP and DBP ≤90 and 94th percentile); arterial hypertension (SBP and DBP &gt; 95th percentile). ROC analysis was used to study the relationship between WC, WHtR and BMI. The distinctive impact of  WC or WHtR on the development of these states was expressed as the area under the curve (AUC 95% CI). Results From 1519 studied teenagers of 12-13 years, boys were 49.1% (n = 745), girls 50.9% (n = 774). Population with normal BP composed 62.7%, normal raised BP - 24.8%, hypertension - 12.4%, WC˂90th percentile at 98.5% (n = 939). The distribution by sex was: girls are more likely to have abdominal obesity than boys, (χ²=19.940, df = 1, р˂0.001). An elevated level of  WHtR was detected in 7.6% (n = 115) of adolescents. Among boys were 7.7% (n = 57) and girls 7.5% (n = 58), χ²=0.013, df = 1, p = 0.908. ). Girls (10.8%) with high blood pressure have increase WC than boys (2.1%), χ²=26.689, df = 1, р˂0.001. Adolescents with high blood pressure have enhanced WHtR - 12.2% than adolescents with normal blood pressure (2.7%), χ²=27.518, df = 1, р˂0.001. Increase of WC &gt; 90th percentile enhances with 4.5 times (95% CI: 2.44-8.53) and WHtR with 2.7 times (95% CI: 1.85-4.04) in adolescents with high blood pressure. WC (AUC = 832; 95% CI: 0.792-0.872) and WHtR (AUC = 0.812; 95% CI: 0.770-0.854was a better predictor of abdominal obesity than BMI. Conclusions. Indicators of  WC, WHtR indicating to the presence of abdominal obesity to identify risk factors for the development of high blood pressure. Participants with increase of  WC &gt; 90th percentile were 4.5 times and WHtR were 2.7 times more likely to have high blood pressure.


Author(s):  
Xijie Wang ◽  
Yanhui Dong ◽  
Zhiyong Zou ◽  
Jun Ma ◽  
Zhaogeng Yang ◽  
...  

Objective: To investigate the relationship between low birthweight (LBW) and blood pressure and to assess whether LBW leads to a higher risk of high blood pressure (HBP) by gender in Chinese students aged 6–18 years. Also, to investigate whether the association was affected by childhood obesity. Methods: Data was obtained from a baseline dataset of a national school-based program. Anthropometric parameters, including height, weight, and blood pressure, were measured, while birthweight and other characteristics were obtained from questionnaires. Stratified chi-squared tests were used to compare the prevalence of HBP between LBW and normal birthweight (NBW) groups in each age and sex category. Multivariable logistic regressions were conducted to estimate the HBP risks in each birthweight group. Results: Both systolic and diastolic blood pressure showed a U-shaped relationship with increased birthweight. Compared to NBW groups, LBW girls showed a higher HBP risk, with an odds ratio of 1.29 (95% confidence interval (CI): 1.02, 1.64, p = 0.033), regardless of their current body mass index status, while no significant association in boys was found. Conclusions: Low birthweight is associated with higher HBP risk in adolescent girls, regardless of their childhood BMI status.


2020 ◽  
Author(s):  
Rajan Shrestha ◽  
Bijay Khatri ◽  
Madan P. Upadhyay ◽  
Janak R. Bhattarai ◽  
Manish Kayastha ◽  
...  

Abstract Background: Obesity has become a global epidemic with a rise in noncommunicable diseases. It is now becoming the problem of low- and middle-income countries such as Nepal. Conventional risk factors are present in a high proportion in the Nepalese population. As a routine surveillance or registry system is absent, the actual burden and trend of obesity and hypertension in Nepal are unknown. Hypertension and other cardiovascular diseases can be prevented by detecting risk factors such as obesity and high blood pressure. A simple anthropometric measurement could be used to determine the risk of hypertension. However, the best predictor of hypertension remains contentious and controversial. We aimed to determine the burden of obesity and hypertension and test the ability to determine hypertension through different anthropometric measurements in hospital outpatients in a low-income setting.Methods: This hospital-based cross-sectional descriptive study was conducted from June to December 2019 among 40-69 year outpatients in a tertiary eye and ENT hospital in a semi-urban area of Nepal among a randomly selected sample of 2,256 participants from 6,769 outpatients visited in Health Promotion and risked factor screening service. We performed a correlation analysis to determine the relationship between anthropometric measurements and blood pressure. The area under the receiver operating characteristic (ROC) curve of body mass index (BMI), waist to height ratio (WHtR) and waist circumference (WC) was calculated and compared.Results: The mean (SD) age of the participants was 51.75 (8.47) years. The overall prevalence of obesity and overweight by BMI was 16.09% and 42.20%, respectively. The overall prevalence of abdominal obesity by waist-to-height ratio was 32.76%, which is higher than obesity by BMI. High waist circumference was observed among 66.76% participants, whereas female participants had a very higher prevalence of high waist circumference (77.46%) and male participants (53.73%) (p<0.001). The prevalence of hypertension among the participants with BMI≥25 kg/m2, WHtR≥0.5 and WC≥ cutoff values was 45.97%, 42.52% and 45.28%, respectively. The overall prevalence of hypertension and prehypertension was 40.67% and 36.77%, respectively. Male participants had a slightly higher prevalence of hypertension (42.72%) than female participants (39.00%). The areas under the curve (AUCs) were significantly higher than 0.5 for BMI (0.570, 95% CI: 0.548-0.592), WC (0.585, 95% CI: 0.563-0.607) and WHtR (0.586, 95% CI: 0.564-0.608). In both genders, the area under the curve was significantly higher than 0.5 (P<0.01). In all age groups, the area under the curve was also significantly higher than 0.5.Conclusion: Waist circumference was both correlated as well as had higher predictive capacity amongst WHtR and BMI and may play a major role in the future diagnosis of HTN in Nepali adults. Regardless of the anthropometric metrics used to measure overweight and obesity, the hospital setting is an opportunity centre to screen for overweight, obesity and hypertension, which are major risk factors for NCDs.


2017 ◽  
Vol 57 (2) ◽  
pp. 84
Author(s):  
Kristina Ambarita ◽  
Oke Rina Ramayani ◽  
Munar Lubis ◽  
Isti Ilmiati Fujiati ◽  
Rafita Ramayati ◽  
...  

Background Diagnosing hypertension in children and adolescents is not always straightforward. The blood pressure-to-height ratio (BPHR) has been reported as a screening tool for diagnosing hypertension.Objective To evaluate the diagnostic value of blood pressure-to-height ratio for evaluating hypertension in adolescents.Methods A cross-sectional study was conducted among 432 healthy adolescents aged 12-17 years in Singkuang, North Sumatera from April to May 2016. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. ROC curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Optimal thresholds of BPHR were determined and validated using 2x2 table analyses.Results The accuracies of BPHR for diagnosing hypertension were > 90% (P<0.001), for both males and females. Optimal SBPHR and DBPHR thresholds for defining hypertension were 0.787 and 0.507 in boys, respectively, and 0.836 and 0.541 in girls, respectively. The sensitivities of SBPHR and DBPHR in both sexes were all >93%, and specificities in both sexes were all >81%. Positive predictive values for SBPHR and DBPHR were 38.7% and 45.2% in boys, respectively; and 55.9% and 42.4% in girls, respectively; negative predictive values in both sexes were all >97%, positive likelihood ratios in both sexes were all >5, and negative likelihood ratios in both sexes were all <1.Conclusion Blood pressure-to-height ratio is a simple screening tool with high sensitivity and specificity for diagnosing hypertension in adolescents.


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Mostafa A. Abolfotouh ◽  
Sunny A. Sallam ◽  
Mohammed S. Mohammed ◽  
Amany A. Loutfy ◽  
Ali A. Hasab

Aim. To investigate the relationship between high blood pressure (HBP) and obesity in Egyptian adolescents.Methods. A cross-sectional study of 1500 adolescents (11–19 years) in Alexandria, Egypt, was conducted. Resting BP was measured and measurements were categorized using the 2004 fourth report on blood pressure screening recommendations. Additional measures included height, weight, and waist and hip circumferences. Obesity was determined based on BMI, waist circumference (WC) and waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) indicators. Crude and adjusted odds ratios were used as measures of association between BP and obesity.Results. Prevalence rates of prehypertension and hypertension were 5.7% and 4.0%, respectively. Obesity was seen in 34.6%, 16.1%, 4.5%, and 16.7% according to BMI, WHR, WC, and WHtR, respectively. Adjusting for confounders, HBP was significantly associated with overall obesity based on BMI (OR=2.18, 95%,CI=1.38-3.44) and central obesity based on WC(OR=3.14, 95%,CI=1.67-5.94).Conclusion. Both overall obesity and central obesity were significant predictors of HBP in Egyptian adolescents.


2011 ◽  
pp. 208-211 ◽  
Author(s):  
B.S. Motswagole ◽  
H.S. Kruger ◽  
M. Faber ◽  
J.M. Van Rooyen ◽  
J.H. De Ridder

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