Prehypertension and Cardiovascular Risk Factors in Children and Adolescents Participating in the Community-Based Prevention Education Program Family Heart Study

BACKGROUND Because prehypertension identifies children most at risk for the development of future hypertensive disease, the purpose of this study was, to examine the association of prehypertension with risk factors for cardiovascular disease (CVD) in a large sample of youths participating in the community-based prevention education program family heart study. METHODS We estimated blood pressure and body mass index (BMI) for age and the lipid profile in terms of total cholesterol (TC), low-density-lipoprotein-cholesterol (LDL-C), high-density-lipoprotein-cholesterol (HDL-C), non-HDL-C, triglycerides (TG) and the LDL-C to HDL-C ratio. RESULTS Among 10,841 (5,628 males) children and adolescents 1,587 (14.6%) had prehypertension (85(th) to <95(th) percentile). This was strongly affected by weight, resulting in 19.7% in overweight (BMI ≥85(th) percentile) and 23.7% in obese (>95(th) percentile) youth. The prevalence of dyslipidemia was similar in prehypertensive boys and girls in terms of LDL-C 11.2% versus 11.8%, non HDL-C 11.9% versus 14.3%, TG 2.4% versus 2.7% and for low HDL-C 2.1% versus 2.3%. The prevalence of low HDL-C increased from 2.1% in non-overweight, through 3.9% in overweight to 5.2% in obese youth and of elevated TG from 1.2% via 4.5% to 6.5% respectively. The number of risk factors is affected by BMI. Significant associations between prehypertension and CVD risk factors were observed in boys and girls for overweight/obesity odds ratios (OR 2.0/2.4), for hypertriglyceridemia (OR 1.9/2.0), for high non HDL-C (OR 1.4/1.4) and for elevated LDL-C (OR 1.3/1.1). CONCLUSIONS Prehypertension was significantly associated with overweight, obesity and dyslipidemia in 10,841 children and adolescents.