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Published online March 1, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. 544-553 (doi:10.1542/peds.2006-2136)
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REVIEW ARTICLE

Has Blood Pressure Increased in Children in Response to the Obesity Epidemic?

Arnaud Chiolero, MD, MSca, Pascal Bovet, MD, MPHa, Gilles Paradis, MD, MScb, Fred Paccaud, MD, MSca

a Community Prevention Unit, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
b Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada

The associations between elevated blood pressure and overweight, on one hand, and the increasing prevalence over time of pediatric overweight, on the other hand, suggest that the prevalence of elevated blood pressure could have increased in children over the last few decades. In this article we review the epidemiologic evidence available on the prevalence of elevated blood pressure in children and trends over time. On the basis of the few large population-based surveys available, the prevalence of elevated blood pressure is fairly high in several populations, whereas there is little direct evidence that blood pressure has increased during the past few decades despite the concomitant epidemic of pediatric overweight. However, a definite conclusion cannot be drawn yet because of the paucity of epidemiologic studies that have assessed blood pressure trends in the same populations and the lack of standardized methods used for the measurement of blood pressure and the definition of elevated blood pressure in children. Additional studies should examine if favorable secular trends in other determinants of blood pressure (eg, dietary factors, birth weight, etc) may have attenuated the apparently limited impact of the epidemic of overweight on blood pressure in children.

Key Words: blood pressure • hypertension • obesity • trends • epidemiology

Abbreviations: BP—blood pressure • CVD—cardiovascular disease • NHANES—National Health and Nutrition Examination Survey

Accepted Oct 23, 2006.


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