Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T03:32:02.294Z Has data issue: false hasContentIssue false
  • English
  • Français

Measurements of adipocity and high blood pressure among children and adolescents living in Belo Horizonte

Published online by Cambridge University Press:  09 July 2009

Robespierre C. Ribeiro ,
Joel A. Lamounier ,
Reynaldo G. Oliveira ,
Isabela M. Bensenor  and
Paulo A. Lotufo
Robespierre C. Ribeiro
Affiliation:
Department of Cardio-Pneumology, School of Medicine, University of São Paulo, São Paulo, Brazil
Joel A. Lamounier
Affiliation:
Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil;
Reynaldo G. Oliveira
Affiliation:
Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil;
Isabela M. Bensenor
Affiliation:
Department of Internal Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil Division of Internal Medicine, Hospital Universitário, University of Sao Paulo, Brazil
Paulo A. Lotufo*
Affiliation:
Department of Cardio-Pneumology, School of Medicine, University of São Paulo, São Paulo, Brazil Department of Internal Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil Division of Internal Medicine, Hospital Universitário, University of Sao Paulo, Brazil
*
Correspondence to: Paulo A. Lotufo, M.D., Dr PH, Av. Lineu Prestes, 2565, 05508-000 São Paulo, SP, Brazil. Tel: +55-11-3091-99485; Fax: +55-11-3091-93000; E-mail: palotufo@hu.usp.br
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects.

Design

Cross-sectional study.

Setting

A school-based study in Belo Horizonte, Brazil.

Participants

We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study.

Main measures of outcome

We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, and resting systolic and diastolic blood pressures using a mercury sphygmomanometer.

Results

In univariate analyses, body mass index greater or lesser than 85th percentile, measurements of skin thickness in the subscapular and suprailiac areas, and the sum of all measurements of skinfold thickness, were associated with both systolic and diastolic measurements of blood pressure. After multivariate analyses that adjusted for all measurements of adiposity except itself, and age, race, and socioeconomic state, we found that the increased body mass index was associated with a 3.6-fold increased frequency of elevated systolic measurements of blood pressure, with 95% confidence intervals from 2.2 to 5.8, and a 2.7-fold increased frequency of elevated measurements of diastolic blood pressure, with 95% confidence intervals from 1.9 to 4.0.

Conclusions

Body-mass index serves as a better predictor of elevated blood pressure among children than do local measurements of adiposity.

Keywords

Overweightobesitybody mass indexcardiovascular risk factorsBrazil
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 5 , October 2009 , pp. 436 - 440
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Murray, CJL, Lopez, AD. The Global Burden of Disease: A comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Harvard University Press, Boston, 1996.Google Scholar
2. Yusuf, S, Reddy, S, Ôunpuu, S, Anand, S. Global burden of cardiovascular diseases, part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104: 2746–2753.CrossRefGoogle ScholarPubMed
3. Yusuf, S, Hawken, S, Ounpuu, S, et al. INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364: 937–952.CrossRefGoogle ScholarPubMed
4. Sichieri, R, Coitinho, DC, Leao, MM, Recine, E, Everhart, JE. High temporal, geographic, and income variation in body mass index among adults in Brazil. Am J Public Health 1994; 84: 793–798.CrossRefGoogle ScholarPubMed
5. Monteiro, CA, Benicio, MH, Conde, WL, Popkin, BM. Shifting obesity trends in Brazil. Eur J Clin Nutr 2000; 54: 342–347.CrossRefGoogle ScholarPubMed
6. Lotufo, PA. Increasing obesity in Brazil: predicting a new peak of cardiovascular mortality. Sao Paulo Med J 2000; 118: 161–162.CrossRefGoogle ScholarPubMed
7. Guo, SS, Roche, AF, Chumela, WC, Gardner, JD, Siervogel, RM. The predictive value of childhood body-mass-index values for overweight at age 35 y. Am J Clin Nutr 1994; 59: 810–819.CrossRefGoogle ScholarPubMed
8. Popkin, BM, Richards, MK, Monteiro, CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 1996; 126: 3009–3016.CrossRefGoogle ScholarPubMed
9. Pietrobelli, A, Steinbeck, KS. Paediatric obesity: what do we know and are we doing the right thing? Int J Obesity 2004; 28: 2–3.CrossRefGoogle ScholarPubMed
10. Marks, GC, Habicht, JP, Mueller, WH. Reliability, dependability, and precision of anthropometric measurements. The Second National Health and Nutrition Examination Survey 1976–1980. Am J Epidemiol 1989; 130: 578–587.CrossRefGoogle ScholarPubMed
11. Garn, SM, Leonard, WR, Hawthorne, VM. Three limitations of the body mass index. Am J Clin Nutr 1986; 44: 996–997.CrossRefGoogle ScholarPubMed
12. Daniels, SR, Khoury, PR, Morrison, JA. The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender. Pediatrics 1997; 99: 804–807.CrossRefGoogle ScholarPubMed
13. Freedman, DS, Khan, LK, Serdula, MK, Dietz, WH, Srinivasan, SR, Berenson, GS. Inter-relationships among childhood BMI, childhood height, and adult obesity: the Bogalusa Heart Study. Int J Obesity 2004; 28: 10–16.CrossRefGoogle ScholarPubMed
14. Reich, A, Müller, G, Gelbrich, G, Deutscher, K, Gödicke, R, Kiess, W. Obesity and blood pressure-results from the examination of 2365 schoolchildren in Germany. Int J Obesity 2003; 27: 1459–1464.CrossRefGoogle ScholarPubMed
15. Kish, Leslie. Survey Sampling. John Wiley & Sons, New York, 1965.Google Scholar
16. Oliveira, RG, Lamounier, JA, Oliveira, ADB, Danasio, M, Oliveira, JS. Pressão arterial em escolares e adolescentes – Estudo de Belo Horizonte. Jornal de Pediatria 1999; 75: 256–266 [in Portuguese].CrossRefGoogle Scholar
17. Medical Subject Headings-MeSH Database. National Library of Medicine. Available at: http://www.ncbi.nih.gov/mesh/2002/Mbrowser.htmlGoogle Scholar
18. Gibson, R. Nutritional Assessment. Oxford University Press, New York, NY, 1993.Google Scholar
19. Frolich, ED, Grim, C, Labarthe, DR, Maxwell, MH, Perloff, D, Weidman, WH. Recommendations for human blood pressure determinations by sphygmomanometers: report of a Special Task Force Appointed by the Steering Committee. American Heart Association. Hypertension 1988; 11: 209A–222A.Google Scholar
20. Brazilian Association of Market Research Institutes (Associação Brasileira dos Institutos de Pesquisa de Mercado – ABIPEME). Available at: 〈http://www.abipeme.org.br〉.Google Scholar
21. Weststrate, JA, Deurenberg, P, van Tinteren, H. Indices of body fat distribution and adiposity in Dutch children from birth to 18 years of age. Int J Obes 1989; 13: 456–477.Google ScholarPubMed
22. Chiolero, A, Bovet, P, Paradis, G, Paccaud, F. Has blood pressure increased in children in response to the obesity epidemic? Pediatrics 2007; 119: 544–553.CrossRefGoogle Scholar