Association Between Blood Pressure And BMI, FMP, Waist Circumference Among Children And Adolescents Aged 3-17 Years In Beijing

Background:Hypertension is known as the most common chronic cardiovascular disease(CVD),there were almost 200 million hypertension patients in our country according to the report of cardiovascular diseases in China(2008-2009).The onset age of hypertension becomes youger and younger.There is a great deal of evidence that high blood pressure often begins in childhood. Long period of continued high blood pressure increase the target organ damage.It's an important direction to reduce disease burdern of hypertension by controlling the blood pressure in children and adolesents.At the same time,the global increasing prevalence of overweight and obesity in children and adolescents not only affect the healthy growth for children,but also threaten the healthy in adults.Obesity in children could continue to adults.Obesity in children and adolescents could increase the prevalence of obesity in adults,and also increase the risk of cardiovascular disease.Objective:To describe the prevalence of obesity and hypertension in children and adolescents in Beijing;To analyze the relationship between blood pressure and BMI,FMP,Waist circumference;To analyze the predication of obesity and phenotype of obesity on hypertension.Methods:Subject and data collection:As a part of Beijing child and adolescents metabolic syndrome study(BCAMS),21 396 children and adolescents aged 3-17 years were involved, blood pressure and waist circunference of 21396 children aged 3-17 years,fat mass percentage of 19780 children aged 6-17 were obtained.Definition and Grouping:The overweight and obesity were defined according to age-gender-specific BMI, waist circumference and Fat mass percentage(FMP);hypertension was defined by SBP and DBP.Statistical Analysis:Skewed distribution were used for describe BMI,FMP,Wasit circumference,SBP and DBP.Analysis of covariance (ANVONA) was used to compare levels of SBP and DBP among different groups for BMI,FMP,waist circumference,Chi-square test was used for category variables.Relationships of SBP and DBP with BMI,FMP,Waist circumfenrence were expressed by partial correlation coefficients.Multiple binary logistic regression models were performed to compare the relative risk of hypertension among different weight groups.Age,gender and living area were controlled as covariates.P<0.05 was denoted statistical significance.Results:1. The prevalence of overweight and obesity diagnosed by BMI,waist circumference and FMP:When diagnosed by BMI,the total prevalence of overweight was 21.7%,for male 26.8%,female 16.5%,and total prevalence of obesity was 9.9%,for male 12.6%,female 7.1%;when diagnosed by waist circumference, total prevalence of obesity was 16.2%,for male 18.4%,female 14.0%; When diagnosed by FMP,the total prevalence of overweight was 9.5%,for male 6.6%,female 12.6%,and total prevalence of obesity was 3.4%,for male 2.0%,female 4.9%;2. The prevalence of hypertension in children and adolescents:The totalprevalence of hypertension in children aged 3-17years in Beijing was 8.9%,for male 9.7%and 8.1%for female.For both male or female.the rate of hypertension were reducing from 3years to 10years,and then were rising from 10 to 14 years,after 14years,falling continuously until 16years,with 17 years,the rate were rising fast.From 3 to 6 years,the prevalence of hypertension girls was higher than in boys,but after 7 years,boys was higher than girls.3. The relationship between weight,waist circumference,BMI,FMP and SBP, DBP:After adjusted by age,gender and urban-rural residence,the partial correlation results suggested that BMI,waist circumference and FMP were positively correlated with SBP and DBP,SBP and DBP were incressing continuously following by the increasing BMI,waist circumference and FMP.4. The correlation of hypertension and obesity diagnosed by BMI,waist circumference and FMP in children:the prevalence of hypertension was increasing from normal weight,overweight to obesity whenever diagnosed by BMI,waist circumference or FMP.The risk of hypertension in obese children was 4 to 6 times of that in normal weight children.5. The correlation of hypertension and phenotype of obesity in children:diagnosed by BMI and waist circumference to normal weight,obesity only for BMI,central obesity and communicative obesity,the prevalence of hypertension was increasing following the four groups.when diagnosed by BMI and FMP,the same result was found,both in girls and boys.Conclusion:The prevalence of obesity and hypertension were high in children and adolescents in Beijing.Overweight and obesity increase the risk of hypertension in children.Obestiy diagnosed by BMI and waist circumference could predict hypertension in children and adolescents effectively.