Blood pressure and adiposity in children and adolescents.

BACKGROUND Although obesity is associated with important hemodynamic disturbances, there are few data on population-wide blood pressure (BP) distribution in children and adolescents in this era of endemic pediatric obesity. METHODS AND RESULTS We conducted a school-based survey of a representative sample of youth aged 9, 13, and 16 years in Quebec, Canada. Resting BP was measured with an oscillometric device in 3589 subjects (80% response). Additional measures included height, weight, and subscapular and triceps skinfold thickness, an age-appropriate questionnaire, and a fasting blood draw. Mean (SD) systolic/diastolic BP (SBP/DBP) levels in 9-, 13-, and 16-year-olds were 103 (9)/57 (6), 113 (12)/58 (7), and 124 (14)/61 (7) mm Hg in males and 103 (10)/57 (6), 111 (11)/60 (7), and 114 (11)/62 (7) mm Hg in females. The prevalence of high-normal or elevated SBP was 12%, 22%, and 30% among 9-, 13-, and 16-year-old males, respectively, and 14%, 19%, and 17% among same-aged females. The prevalence of high-normal or elevated DBP was <1%. In multiple linear regression analysis, body mass index was consistently associated with SBP and DBP in all age-gender groups. CONCLUSIONS Mean SBP and the prevalence of high-normal and elevated SBP are elevated in children and adolescents. Public policy, public health programs, and clinical preventive measures are urgently needed to address the obesity epidemic and its hemodynamic consequences.