Hypertension in childhood obesity

Acta Paediatr. 2019 Jan;108(1):37-43. doi: 10.1111/apa.14551. Epub 2018 Sep 19.

Abstract

Aim: The prevalence of childhood hypertension is rising in parallel with global increases in the prevalence of overweight and obesity. We looked at key papers and documents covering three decades.

Methods: This mini review examined a wide range of material published in English, with the main focus on 1993-2018, including clinical trials, meta-analyses, guidelines and data produced by the World Health Organization and the World Obesity Federation.

Results: The literature showed that body weight and blood pressure are closely correlated and obesity-related hypertension contributes further to the clustering of cardiovascular risk factors in obesity. Because the duration of hypertension affects the risk of end-organ damage, timely diagnosis and initiation of treatment are important. First-line interventions should aim for blood pressure control and weight reduction. However, lifestyle modifications are often not successful with regard to attaining and maintaining long-term blood pressure and weight control, despite a multidisciplinary approach. Antihypertensive treatment is recommended for all hypertensive children with failure of nonpharmacological treatment, diabetes, secondary hypertension, stage 2 hypertension or target organ damage.

Conclusion: We found that obesity-related hypertension was associated with a significantly increased cardiovascular morbidity and mortality, and early diagnosis and treatment for blood pressure control and weight reduction is essential.

Keywords: Cardiovascular risk; Children; Hypertension; Obesity; Overweight.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Antihypertensive Agents / therapeutic use*
  • Body Mass Index*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / therapy
  • Child
  • Comorbidity
  • Diet, Reducing
  • Exercise / physiology
  • Female
  • Global Health
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / epidemiology*
  • Incidence
  • Life Style
  • Male
  • Pediatric Obesity / diagnosis
  • Pediatric Obesity / epidemiology*
  • Pediatric Obesity / therapy
  • World Health Organization

Substances

  • Antihypertensive Agents