BMC Public Health. 2025 Dec 23;25(1):4286. doi: 10.1186/s12889-025-25463-5.
ABSTRACT
BACKGROUND: In recent years, the incidence of hypertension in children and adolescents has gradually increased, becoming a public health issue of global concern. Current evidence has established a correlation between body mass index (BMI) and blood pressure in adult populations, whereas the nature of this association remains inconclusive in pediatric population. Therefore, in this study, we explored the association between BMI and blood pressure in children and adolescents.
METHODS: This cross-sectional study included 8,157 children and adolescents aged 6-17 years in Zhangwu County, Liaoning Province. From February to September 2022, we collected the hypertension risk factor questionnaire and completed anthropometric measurements and blood pressure measurements. BMI was calculated as (weight (kg)/height (m)2), and categorized into four groups: underweight, normal weight, overweight and obesity based on percentile thresholds. Blood pressure was classified into normal blood pressure, prehypertension, stage one hypertension, and stage two hypertension in accordance with the definition criteria of the American Academy of Pediatrics. One-way analysis of variance (ANOVA), Kruskal-Wallis test, chi-square test, and ordinal logistic regression analysis were all performed to explore the correlation between BMI and blood pressure. SPSS 27.0 statistical software and SPSS AU were used for statistical analysis.
RESULTS: The overall prevalence of hypertension was 20.4%, with a prevalence of 19.9% in boys and 20.8% in girls. The blood pressure categories increased with the elevation of BMI categories (all P < 0.001). A significant association between BMI categories and blood pressure categories was observed in both the unadjusted model (prehypertension: OR = 5.01, 95%CI: 4.52-5.55; stage one hypertension: OR = 10.09, 95%CI: 9.03-11.26; stage two hypertension: OR = 108.54, 95%CI: 91.05-129.38; all P < 0.001) and the model adjusted for age and smoking (prehypertension: OR = 6.05, 95%CI: 4.91-7.46; stage one hypertension: OR = 12.20, 95%CI: 9.86-15.08; stage two hypertension: OR = 131.39, 95%CI: 102.02-169.20; all P < 0.001).
CONCLUSION: Overweight and obesity may represent a potential risk factor for high blood pressure in the pediatric population. These findings underscore the importance of early weight management to mitigate the long-term risk of cardiovascular diseases.
PMID:41436984 | DOI:10.1186/s12889-025-25463-5
