Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1157-e1164 (doi:10.1542/peds.2007-0306)
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ARTICLE

Obesity Is a Common Comorbidity in Children With Congenital and Acquired Heart Disease

Nelangi M. Pinto, MDa, Bradley S. Marino, MD, MPP, MSCEa, Gil Wernovsky, MDa, Sarah D. de Ferranti, MD, MPHb, Amy Z. Walsh, RNb, Meena Laronde, RNb, Kristen Hyland, BAa, Stanley O. Dunn, Jr, BAa and Meryl S. Cohen, MDa

a Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
b Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts

OBJECTIVES. Obesity may pose additional cardiovascular risk to children with acquired and congenital heart disease. Many children with heart disease are sedentary as a result of physician-, parent-, and/or self-imposed restrictions. The aim of this study was to evaluate the impact of the epidemic of obesity on children with heart disease.

PATIENTS AND METHODS. A cross-sectional review was performed of children evaluated in 2004 at 2 cardiology outpatient clinics. Differences in the prevalence of obese (BMI ≥ 95%) and overweight (BMI 85%–95%) children were compared with national data and healthy control subjects. Dictated letters were reviewed to determine whether obesity was discussed with referring practitioners.

RESULTS. Of 2921 patients assessed, 1523 had heart disease. Diagnostic subgroups included "mild" heart disease (n = 401), arrhythmia (n = 447), biventricular repair (n = 511), univentricular palliation (Fontan; n = 108), and heart transplantation (n = 56). More than 25% of the patients with heart disease were obese or overweight; the prevalence of obese and overweight children was significantly lower only in the Fontan group (15.9%). Pediatric cardiologists failed to document obesity or weight counseling in the majority of clinic letters.

CONCLUSIONS. Obesity is common in children with congenital and acquired heart disease. Pediatric cardiologists demonstrate inadequate communication regarding this problem to referring practitioners. Healthy-lifestyle counseling and routine exercise in children with heart disease may be underemphasized.

Key Words: obesity • pediatric • congenital heart disease • BMI

Abbreviations: NHANES—National Health and Nutrition Examination Survey • CHOP—Children's Hospital of Philadelphia • CHB—Children's Hospital Boston • EP—electrophysiology

Accepted Apr 16, 2007.


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