Effect of changes in BMI andwaist circumference on ambulatory blood pressure in obese children and adolescents

Kristian Nebelin Hvidt*, Michael Hecht Olsen, Hans Ibsen, Jens Christian Holm

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

Background: Weight reduction has been accompanied with a reduction in clinic blood pressure (BP) in children and adolescents; however, the effect on ambulatory BP (ABP) is uncertain. The objective was to investigate the impact of weight changes on ABP in obese children and adolescents. Methods: Sixty-one severely obese patients aged 10-18 years underwent lifestyle intervention at the Children's Obesity Clinic. Patients were examined with ABP monitoring at baseline and after 1 year of treatment (follow-up). To account for growth, BP and BMI were standardized into z scores, whereas waist circumference was indexed by height [waist/height ratio (WHR)]. Results: Patients experienced a reduction at follow-up in the degree of obesity [DBMI z score: -0.21, 95% confidence interval (CI) -0.32 to -0.10, P=0.0003; and DWHR: -0.02, 95% CI -0.03 to -0.004, P=0.009]. D24-h, Ddaytime and Dnight-time SBP and DBP in mmHg and changes in equivalent z scores were related to DBMI z scores and DWHR. These relationships were reproduced in multiple regression analyses adjusted for relevant confounders, for example, a reduction in one BMI z score corresponds to a reduction in 24-h SBP by 6.5mmHg (P<0.05). No relationship was found between changes in these anthropometric obesity measures and changes in clinic BP. Conclusion: Changes in obesity measures were closely related to changes in ABP, but not to changes in clinic BP, in severe obese children and adolescents after 1 year of lifestyle intervention. The findings emphasize the use of 24-h ABP measurements in children and adolescents.

OriginalsprogEngelsk
Sider (fra-til)1470-1477
Antal sider8
TidsskriftJournal of hypertension
Vol/bind32
Udgave nummer7
DOI
StatusUdgivet - jul. 2014

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