Body Mass Index, Waist Circumference, Hip Circumference, Waist-To-Height Ratio: Which Affects Adolescent Hypertension More?

Year 2023, Volume: 5 Issue: 1, 17 - 22, 01.03.2023

Melike Tellioğlu , Muammer Yılmaz , İnci Arıkan , Yaşar Çakmakçı

https://doi.org/10.38175/phnx.1207088

Abstract

Introduction: To determine the prevalence of hypertension in adolescents, its relationship with obesity, and which of the BMI, waist circumference (WC), hip circumference (HC), and waist-height ratio (WHtR) affect adolescent hypertension more.
Material and Methods: In this cross-sectional study, the weights, heights, WC, HC, blood pressure and sociodemographic data measured in May 2019 for students aged 14-18 were analyzed retrospectively. Among the 4580 high school students aged 14-18, 4529 students with complete data were included in the study. Weight, height, waist circumference, hip circumference, blood pressure were measured in students. The predictive values of the variables causing high blood pressure were measured.
Results: The prevalence of hypertension in 4529 students included in the study was 14.3% as 36.5% in the obese and 12.3% non-obese (p<0.001). In correlation analysis, a significant correlation was found between systolic (SBP) and diastolic blood pressures (DBP) and BMI, WHtR, and WC (p<0.001). 34% of SBP can be explained by WC (R2:0.346), 25% by BMI (R2:0.25), 34% by WHtR (R2:0.34) and 24% by HC (R2:0.24) while 20% of the DBP can be explained by WHtR (R2:0.20), 15% by BMI (R2:0.15), 20% by WC (R2:0.20) and 15% by HC (R2:0.15).
Conclusion: BMI, WHtR and WC have a greater effect on SBP than DBP. BMI has less contribution to the development of hypertension compared to WHtR and WC.

Keywords

adolescent, body mass index, hip circumference, hypertension, waist circumference, waist-height ratio

Supporting Institution

Yok

Project Number

Yok

Thanks

All study participants who voluntarily participated in the study deserve thanks. We also would like to acknowledge to the Tavsanli District Health Directoratefor all the support.

Vücut Kitle Indeksi, Bel Çevresi, Kalça Çevresi, Bel-Boy Oranı: Hangisi Adölesanlarda Hipertansiyonu Daha Çok Etkiler?

Abstract

Amaç: Adölesanlarda hipertansiyon prevalansı, obezite ile ilişkisi ve vücut kitle indeksi (BMİ), bel çevresi, kalça çevresi, bel-boy oranından hangisinin adolesan hipertansiyonunu daha çok etkilediğinin belirlenmesi amaçlandı.
Gereç ve Yöntemler: Çalışma tanımlayıcı kesitsel tiptedir. 14-18 yaş aralığındaki öğrencilerde 2019 Mayıs ayında ölçülen ağırlıkları, boyları, bel çevresi, kalça çevresi, kan basınçları ve sosyodemografik verileri geriye yönelik incelendi.
Bulgular: Çalışmaya alınan 4529 öğrencinin hipertansiyon prevalansı %14,3’tür (n=648). Obezitesi olan grupta hipertansiyon saptananlar 140 (%36,5) kişi, obezitesi olmayanlarda 508 (%12,3) kişi olarak bulundu (p<0,001). Korealasyon analizinde; Sistolik ve Diyastolik kan basınçlarının vücut kütle indeksi, bel-boy oranı, bel çevresi ile arasında anlamlı ilişki bulundu (p<0,001). Lineer regresyon analizi sonucuna göre sistolik kan basıncının %34’ü bel çevresi (R2:0,346), %25’i vücut kütle indeksi (R2:0,25),%34’ü Bel-boy oranı (R2:0,34) %24 ‘ü kalça çevresi (R2:0,24) ile açıklanabilir. Diyastolik kan basıncının ise %20’si bel-boy oranı (R2:0,20), %15’i vücut kütle indeksi (R2:0,15), %20’si bel çevresi ile (R2:0,20)ve %15 ‘i kalça çevresiyle(R2:0,15) açıklanabilir.
Sonuçlar: Vücut kütle indeksi, Bel-boy oranı ve bel çevresinin sistolik kan basıncı üzerine etkisi diyastolik kan basıncından daha fazladır. Hipertansiyon gelişiminde Bel-boy oranı ve bel çevresine göre vücut kütle indeksinin daha az katkısı bulunmaktadır.

Keywords

adölesan, vücut kitle indeksi, kalça çevresi, hipertansiyon, bel çevresi, bel-boy oranı

Project Number

Yok

References

• World Health Organization. Adolescent health. Available at: https://www.who.int/health-topics/adolescent-health#tab=tab_1. Accessed: September 02, 2021.
• T.R. Ministry of Health. Adolescent Health. Available at: https://sagligim.gov.tr/kadin-sagligi/444-saglikli-hayat2/ergen-sagligi.html. Accessed: September 02, 2021.
• Katamba G, Agaba DC, Migisha R, Namaganda A, Namayanja R, Turyakira E. Prevalence of hypertension in relation to anthropometric indices among secondary adolescents in Mbarara, Southwestern Uganda. Ital J Pediatr. 2020;46(1):1-7. doi: 10.1186/s13052-020-00841-4.
• Bruce MA, Beech BM, Norris KC, Griffith DM, Sims M, Thorpe RJ Jr. Sex, Obesity, and Blood Pressure Among African American Adolescents: The Jackson Heart KIDS Pilot Study. Am J Hypertens. 2017;30(9):892-898. doi: 10.1093/ajh/hpx071.
• Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Kuupiel D. Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review. Arch Public Health. 2020;78(1):109. doi: 10.1186/s13690-020-00491-2.
• Barzin M, Aryannezhad S, Serahati S, Beikyazdi A, Azizi F, Valizadeh M, et al. Incidence of obesity and its predictors in children and adolescents in 10 years of follow up: Tehran lipid and glucose study (TLGS). BMC Pediatr. 2018;18(1):245. doi: 10.1186/s12887-018-1224-6.
• Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478. doi: 10.1016/S0140-6736(16)00579-1.
• Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009;27(9):1719-1742. doi: 10.1016/j.anpedi.2010.04.001.
• World Health Organization. Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed: September 02, 2021.
• Ewald DR, Haldeman LA. Risk Factors in Adolescent Hypertension. Glob Pediatr Health. 2016;3:2333794X15625159. doi: 10.1177/2333794X15625159.
• Quaresma FRP, Da Silva Maciel E, Dos Santos Figueiredo FW, Adami F. Factors associated with blood pressure disorders in Afro-descendant children and adolescents. BMC Pediatr. 2019;19(1):244. doi: 10.1186/s12887-019-1626-0.
• T.R. Ministry of Health. Hypertension Clinical Protocol. Ankara: Turkey. T.R. Ministry of Health General Directorate of Health Services; 2020. Available at: https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/hipetansiyon_kp_20200723.pdf. Accessed: September 02, 2021.
• Göknar N, Çalışkan S. New guidelines for the diagnosis, evaluation, and treatment of pediatric hypertension. Turk Pediatri Ars. 2020;55(1):11-22. doi: 10.14744/TurkPediatriArs.2020.92679.
• Puškaš V, Rakić R, Batez M, Sakač D, Pavlica T. Body Mass Index and Blood Pressure-to-Height Ratio in Predicting Incidence of Hypertension in Serbian Children. Children. 2020;7(12):254. doi: 10.3390/children7120254.
• Cheah WL, Chang CT, Hazmi H, Kho GWF. Using Anthropometric Indicator to Identify Hypertension in Adolescents: A Study in Sarawak, Malaysia. Int J Hypertens. 2018;2018:6736251. doi: 10.1155/2018/6736251.
• Bozza R, Campos WD, Barbosa Filho VC, Stabelini Neto A, Silva MP, Maziero RS. High Blood Pressure in Adolescents of Curitiba: Prevalence and Associated Factors. Arq Bras Cardiol. 2016;106(5):411-418. doi: 10.5935/abc.20160044.
• Hao Y, Wang L, Xue B, Wang Y. Associations between general and central obesity and hypertension among children: The Childhood Obesity Study in China Mega-Cities. Sci Rep. 2017;7(1):16895. doi: 10.1038/s41598-017-16819-y.
• Yegül Gülnar G, Kasap Demir B. Çocuk ve Adolesanlarda Obezite İlişkili Hipertansiyon Mekanizmaları. İKÇÜSBFD. 2017;2(2):39-43.
• Cardel MI, Atkinson MA, Taveras EM, Holm JC, Kelly AS. Obesity Treatment Among Adolescents: A Review of Current Evidence and Future Directions. JAMA Pediatr. 2020;174(6):609-617. doi: 10.1001/jamapediatrics.2020.0085.
• Heo S, Kwon S, Lee YM, Shin JY, Lee DH. Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study. J Prev Med Public Health. 2020;53(1):45-55. doi: 10.3961/jpmph.19.198.
• Ramirez LA, Sullivan JC. Sex Differences in Hypertension: Where We Have Been and Where We Are Going. Am J Hypertens. 2018;31(12):1247-1254. doi: 10.1093/ajh/hpy148.
• Zhang X, Yang J, Wang Y, Liu W, Yang W, Gao L, et al. Epidemiological characteristics of elevated blood pressure among middle and high school students aged 12-17 years: a cross-sectional study in Jiangsu Province, China, 2017-2018. BMJ Open. 2019;9(8):e027215. doi: 10.1136/bmjopen-2018-027215.
• Daniel RA, Haldar P, Prasad M, Kant S, Krishnan A, Gupta SK, et al. Prevalence of hypertension among adolescents (10-19 years) in India: A systematic review and meta-analysis of cross-sectional studies. PLoS One. 2020;15(10):e0239929. doi: 10.1371/journal.pone.0239929.
• Georgeson A, Lebenthal M, Catania R, Georgeson S. Obesity and elevated blood pressure in suburban student athletes. BMJ Open Sport Exerc Med. 2017;3:e000276. doi: 10.1136/bmjsem-2017-000276.
• Devonshire AL, Hager ER, Black MM, Diener-West M, Tilton N, Snitker S. Elevated blood pressure in adolescent girls: correlation to body size and composition. BMC Public Health. 2016;16:78. doi: 10.1186/s12889-016-2717-6.
• Zhang X, Zhang F, Yang J, Yang W, Liu W, Gao L, et al. Prevalence of overweight and obesity among primary school-aged children in Jiangsu Province, China, 2014-2017. PLoS One. 2018;13(8):e0202681. doi: 10.1371/journal.pone.0202681.
• Chen Y, Zhang Y, Wang L. Low Diagnostic Accuracy of Body Mass Index-Based and Waist Circumference-Based References of Childhood Overweight and Obesity in Identifying Overfat among Chinese Children and Adolescents. Biomed Res Int. 2018;2018:4570706. doi: 10.1155/2018/4570706.
• Fowokan AO, Punthakee Z, Waddell C, et al. Adiposity measures and their validity in estimating risk of hypertension in South Asian children: a cross-sectional study. BMJ Open. 2019;9(2):e024087. doi: 10.1136/bmjopen-2018-024087.
• Ghosh JR, Bandyopadhyay AR. Central adiposity and the risk of hypertension in Asian Indian girls. World J Pediatr. 2013;9(3):256-260. doi: 10.1007/s12519-013-0424-2.