Overweight, Ethnicity, and the Prevalence of Hypertension in School-Aged Children
* Department of Pediatrics, Division of Pediatric Nephrology and Hypertension
School of Public Health, Department of Biometry, University of Texas Health Science Center, Houston, Texas
Objectives. To describe the current prevalence of pediatric hypertension and the relationships between gender, ethnicity, overweight, and blood pressure.
Methods. School-based screening was performed in 5102 children (13.5 ± 1.7 years) from May through November 2002. Age, gender, ethnicity, weight, and height were ascertained, and body mass index (BMI) was calculated as weight (kg)/height (m2). Overweight was defined as BMI 
95th percentile. Students with blood pressure >95th percentile on the first screening underwent a second screening 1 to 2 weeks later, and then a third screening if blood pressure was >95th percentile at the second screening.
Results. Ethnicity distribution was 44% white, 25% Hispanic, 22% African American, and 7% Asian. Overall, overweight prevalence was 20%, which varied significantly by ethnicity (31% Hispanic, 20% African American, 15% white, and 11% Asian). The prevalence of elevated blood pressure after first, second, and third screenings was 19.4%, 9.5%, and 4.5%, respectively. Elevated blood pressure on first screening was highest among Hispanics (25%) and lowest among Asians (14%). Ethnic differences in the prevalence of hypertension (elevated blood pressure on 3 screenings) were not significant after controlling for overweight. The prevalence of hypertension increased progressively as the BMI percentile increased from 
5th percentile (2%) to 95th percentile (11%). After adjustment for gender, ethnicity, overweight, and age, the relative risk of hypertension was significant for gender (relative risk: 1.50; confidence interval: 1.15, 1.95) and overweight (relative risk: 3.26; confidence interval: 2.50, 4.24).
Conclusions. These results confirm an evolving epidemic of cardiovascular risk in youth, as evidenced by an increase in the prevalence of overweight and hypertension, notably among ethnic minority children.
Key Words: obesity • hypertension • child • epidemiology • ethnicity
Abbreviations: BMI, body mass index • SBP, systolic blood pressure • DBP, diastolic blood pressure • SD, standard deviation • CI, confidence interval
Received for publication Mar 4, 2003; Accepted Jun 6, 2003.
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