Blood pressure among overweight adolescents from urban school children in Pune, India

OBJECTIVES: To examine the magnitude of overweight and its association with blood pressure (BP) among adolescents. DESIGN: Cross-sectional study with all children in age range 9-16 years (n=1146 boys and 1077 girls) from two schools catering to urban affluent high socio-economic class (HSE), for anthropometric measurements by trained investigators and BP measurement by a pediatrician using sphygmomanometer. RESULTS: The prevalence of overweight based on conventional body mass index (BMI) cutoff was 27.5% for boys and 20.9% for girls but varied for different indicators. Prevalence of high systolic blood pressure (HSBP) was 12.0% in boys and 9.7% in girls and increased with increasing levels of BMI, weight, triceps skin fold thickness (TSFT) and percent body fat. Mean level of SBP among overweight children was significantly (P<0.001) higher by about 12 mm Hg, whereas that for diastolic blood pressure was higher by 8 mm Hg (P<0.001) as compared to their non-overweight (age, sex-matched) counterparts. This was true in both sexes and for all indicators used for assessing overweight. Prevalence of HSBP increased suddenly beyond BMI value of 20 kg/m2 in boys and 21.5 kg/m2 in girls, beyond TSFT value of 12 mm for boys and 14 mm for girls whereas such cutoffs for body fat were above 25% in both sexes. These cutoffs appear much lower than the conventional ones and therefore indicate the need for validation of conventional cutoffs in different populations. CONCLUSIONS: Our findings highlight that BP measurement needs to be a routine part of physical examination in school children, and the use of cutoffs anchored to metabolic risks may be essential for assessment of obesity.     

高血压患者治疗后血压昼夜节律及影响因素的调查

目的了解高血压病患者经治疗血压达标后血压昼夜节律及影响因素.方法采用横断面调查的方法,采用进入法进行非条件logistic回归分析.结果共纳人208例患者,呈勺型曲线者79例(占38%),非勺型曲线者129例(占62%).logistic回归分析显示,年龄在70岁以上及60～69之间者24 h动态血压曲线呈非勺型的比例分别是60岁以下者的3.3倍(P=0.009)和2.3倍(P=0.031);有早发心血管疾病家族史的患者,其动态血压曲线形态呈非勺型的比例为无相应家族史患者的3.7倍(P=0.029);超重(BMI＜28)与肥胖(BMI≥28)者24 h动态血压曲线呈非勺型的比例分别是正常体重(BMI＜24)者的3.0倍(P=0.003)和4.8倍(P=0.009);与单独应用长效钙离子拮抗剂(CCBs)治疗相比,单用血管紧张素转换酶抑制剂(ACEIs)或血管紧张素Ⅱ受体阻滞剂(ARBs)治疗者动态血压曲线呈非勺型的机会较少(OR=0.139,P=0.010),采用包含ACEIs或ARBs(但不包括利尿剂)的联合用药方案的患者有较少非勺型曲线的趋势,但二组之间差异无显著性(OR=0.453,P=0.118);采用包括利尿剂(但无ACEIs或ARBs)的联合用药方案以及同时包含利尿剂与ACEIs或ARBs的联合用药方案的患者均有较少非勺型曲线的机会(OR值分别为0.378和0.273,P值分别为0.030和0.011).结论高血压患者经治疗血压达标后,有近三分之二的患者呈异常的血压昼夜节律.年龄、早发心血管疾病的家族史、超重或肥胖、降压药物治疗方案等4个因素与24 h血压曲线形态有关.与单用长效CCBs比较,利尿剂、ACEIs或ARBs可能有利于保持正常的血压昼夜节律.     

Obesity in adults: an emerging problem in urban areas of Ho Chi Minh City, Vietnam

OBJECTIVE: To assess the prevalence of overweight, obesity and underweight among Vietnamese adults living in urban areas of Ho Chi Minh City (HCMC), Vietnam. DESIGN: This cross-sectional survey was conducted in the local health stations of 30 randomly selected wards, which represent all 13 urban districts of HCMC, over a period of 2 months from March to April 2004. SUBJECTS: A total of 1488 participants aged 20-60 years completed the interview, physical examination and venous blood collection. MEASUREMENTS: Anthropometric measurements of body weight, height, waist and hip circumference were taken to construct indicators of adiposity including body mass index (BMI), waist circumference, and waist-to-height and waist-to-hip ratios. Both systolic and diastolic blood pressure and biochemical indicators of cardiovascular disease and type II diabetes risk (lipid profile and fasting blood glucose) were also measured. RESULTS: The age and sex standardized prevalence of overweight and obesity using Asian specific BMI cutoffs of 23.0 and 27.5 kg/m2 was 26.2 and 6.4%, respectively. The prevalence of overweight and obesity was slightly higher in females (33.6%) than males (31.6%), and progressively increased with age. The age and sex-standardized prevalence of underweight (BMI <18.5 kg/m2) among Vietnamese adults living in HCMC was 20.4%. The prevalence was slightly higher in males (22.0%) than in females (18.9%), and there was a much higher prevalence in all underweight categories in younger women than in men but this was reversed for older men. CONCLUSION: The adult population in HCMC Vietnam is in an early 'nutrition transition' with approximately equal prevalence of low and high BMI. The prevalence of overweight and obesity of Vietnamese urban adults was lower than that reported for other east and southeast Asian countries.     

Perceived health risk of excess body weight among overweight and obese men and women: differences by sex

OBJECTIVES: To describe perceptions of health risk from excess body weight among adults, and assess if lack of perceived risk was associated with trying to lose weight. METHODS: Sex-specific logistic regression models were used to determine odds of disagreement that one's weight is a health risk and odds of trying to lose weight among overweight (BMI=25.0-29.9 kg/m(2), n=1296) and obese (BMI> or =30 kg/m(2), n=1335) adult participants in the 2004 Styles' surveys. RESULTS: Men were more likely than women to disagree their body weight was a health risk (among the overweight, 62% vs. 43%; the obese 20% vs. 14% obese). Disagreement with risk was associated with good health status and race/ethnicity among both sexes and lower education and income among women. Odds of currently trying to lose weight were significantly lower among obese men who disagreed, and overweight men and women who were neutral or disagreed that their body weight was a health risk. CONCLUSIONS: Many overweight and obese adults do not perceive their weight to be a health risk; this perception was associated with lower prevalence of trying to lose weight, particularly among men. Discussion by clinicians about the health risks of excess weight may alter perceived risk and help promote weight loss efforts.     

1995-2002年上海宝钢集团职工超重肥胖率的流行趋势

目的探讨上海宝钢集团股份公司（简称宝钢）职工超重和肥胖率的动态变化。方法回顾性分析1995-2002年期间宝钢职工隔年体检资料,根据体质指数（body mass index,BMI）≥24kg／m^2而〈28kg／m^2和≥28kg／m^2分别诊断超重和肥胖,采用SPSS11．5和SAS统计软件进行分析。结果1995-2002年期间共有59131人次参加健康体检,其中参加4次者27．1％,3次者26．6％,2次者占24．0％。总体超重和肥胖率进行性别、年龄校正后,分别从1995-1996年的26．50％和4．10％上升至2001-2002年的34．60％和7．70％。进行年龄校正后,男性超重和肥胖率分别从28．20％和4．20％升高至37．90％和8．40％;女性超重和肥胖率分别从19．60％和3．70％升高至21．10％和5．20％,男性改变更为显著。在男性中,60岁以前各年龄段超重和肥胖率均随时间进展逐年升高;女性除30岁以前年龄段超重率和50-60岁年龄段肥胖率基本表现为逐年升高外,其余年龄段超重和肥胖率变化不明显。结论1995-2002年,上海市宝钢职工超重肥胖率不断增高,其中以中青年男性改变最为显著,该人群应成为疾病防治的重点。     

Body size and blood pressure: an analysis of Africans and the African diaspora

BACKGROUND: Blood pressure is directly and causally associated with body mass index (BMI) in populations worldwide. However, the relationship may vary across BMI in populations of African origin. METHODS: We compared the relationship between blood pressure and BMI in populations of African origin, using 13 samples from Africa, the Caribbean, the United Kingdom and the United States. We had access to data from individual participants for age, height, weight, blood pressure, and treatment of hypertension. Analysis was restricted to 18,072 participants (age 35-64 years; 44% men). We carried out multivariate regression analysis to estimate the relationship between blood pressure and BMI by country and by sex. The use of antihypertensive treatment was taken into account by exclusion and by sensitivity analysis. RESULTS: There was a positive relationship between both systolic and diastolic blood pressure and BMI. In men the slopes for systolic blood pressure varied from 0.27 mm Hg per kg/m (95% confidence interval = -0.01 to 0.56) in the United States to 1.72 mm Hg per kg/m (95% confidence interval = 0.92 to 2.53) in Ghana (Kumasi). In women, the slopes varied from 0.08 (-0.54 to 0.72) in South Africa to 1.32 (0.98 to 1.66) in the Republic of Congo. Similar variation in trends was seen for diastolic blood pressure. The higher the BMI, the shallower the slopes [-0.10 (-0.15 to -0.06) for systolic, -0.09 (-0.12 to -0.06) for diastolic]. No differences were seen after excluding persons who were being treated for hypertension. CONCLUSIONS: Blood pressure and BMI levels vary among populations of the African diaspora. The effect of BMI on blood pressure levels diminishes as BMI increases. These results suggest a complex relationship among excess body weight, adiposity, and energy expenditure.     

德清农村社区成人超重现况及其与空腹血糖异常的关系研究

目的了解当前农村社区成人居民超重状况及其与空腹血糖异常的关系。方法采用流行病学现况研究设计,整群抽取浙江省德清县4个农村社区,使用统一调查表面对面调查上述社区中所有18～64周岁的社区户籍居民5840人的一般人口特征和健康相关内容,同时测量身高、体重、空腹血糖等指标。利用Epidata 3.1中文版建立数据库,SPSS 16.0进行数据分析。结果在5840名调查对象中,平均BMI为22.7±11.6,超重率25.1%,肥胖率3.8%(按照2000年全国人口进行年龄性别标化,标化的超重率为21.8%)。从年龄分布看,无论男性还是女性社区居民的超重率均在35岁之后明显增加,表现出一定的年龄趋势(男:χ2趋势=5.61,P=0.018;女:χ2趋势=50.96,P<0.001;合并:χ2趋势=14.05,P<0.001)。校正了年龄、性别、吸烟、饮酒和规律体育锻炼后,在多分类Logistic回归模型中,与非超重居民相比,超重与较高的空腹血糖受损和糖尿病风险有关,其调整OR(aOR)分别为1.8(95%CI 1.34～2.37)和3.7(95%CI 2.42～5.65),BMI每增加一个单位,空腹血糖受损和糖尿病的风险分别增加14%和24%(aOR=1.14,95%CI 1.10～1.20;aOR=1.24,95%CI 1.16～1.32)。结论德清农村社区成人居民超重率较高,超重既与糖尿病密切相关也与空腹血糖受损有关,值得进一步研究与监测。     

Evolution of the prevalence of obesity in the workers of a general hospital in Mexico

OBJECTIVE: The objective of this study was to compare the prevalence of overweight and obesity in the first Prevalencia de factores de nesso cardiovascular en Trabajadores survey (1994) with the prevalence of overweight and obesity observed in the second survey (1996). RESEARCH METHODS AND PROCEDURES: For both surveys the following individual data were collected: age, sex, weight, height, and body mass index (BMI). The 1994 survey included 2383 people and the 1996 survey included 2759 people. The degree of BMI was classified according to the current World Health Organization definitions. The population was divided by gender and age group, and the prevalence of each level of overweight was calculated. Additionally, the prevalence of different cutoff levels of BMI was calculated by gender and age groups. RESULTS: The global prevalence of age-adjusted overweight increased from 26.91% to 37.45%. This increase was observed in both genders but the men had a higher increase from 24.51% to 40.21%. Overweight was more frequent in men than in women in all age groups. Male overweight prevalence was higher in the 40- to 59-year-old group and > or = 60-year-old group. Female overweight prevalence was predominant in the 30- to 39-year-old, 40- to 49-year-old, and 50- to 59-year-old groups. Global prevalence of obesity (> or =30 kg/m(2)) changed from 13.8% to 17.2%. Particularly, global prevalence of obesity class I increased from 9.66% to 12.6%; in men this figure increased from 9.04% to 13.05% and in women from 9.9% to 12.71%. DISCUSSION: Prevalence of overweight and obesity has increased significantly in the studied population. It is necessary to implement lifestyle modifications to prevent the increase of prevalence of overweight and obesity.     

Distribution of blood pressure, body mass index and smoking habits in the urban population of Dar es Salaam, Tanzania, and associations with socioeconomic status

OBJECTIVE: To estimate the distribution of blood pressure (BP), body mass index (BMI), smoking habits and their associations with socioeconomic status (SES) in an urban population in early epidemiological transition. METHODS: Cross-sectional survey of the entire population aged 25-64 years in five branches of Dar es Salaam (Tanzania) through visits to all homes in the study area. Blood pressure was based on the mean of the second and third readings with an automated device. Socioeconomic status was estimated with indicators of education, occupation and wealth. RESULTS: In all 9254 people were examined. Age-adjusted prevalence (%) among men/ women aged 35-64 years was 27.1/30.2 for BP > or = 140/90 mmHg or antihypertensive medication, 13.1/17.7 for BP > or = 160/95 mmHg or antihypertensive medication, 28.0/27.4 for BMI of 25.0-29.9 kg/m(2), 6.9/17.4 for BMI > or = 30 kg/m(2), and 22.0/2.6 for smoking (> or = 1 cigarette per day). Prevalence of categories of drinking frequency and history of diabetes are also reported. After adjustment for covariates, SES was associated inversely with BP and smoking and directly with BMI. Body mass index was associated positively with BP (1.01 and 0.91 mmHg systolic BP per 1 kg/m(2) BMI in men and women, respectively) and inversely with smoking (-1.14 kg/m(2) in male smokers versus non-smokers). Hypertension treatment rates were low, particularly in people of low SES. CONCLUSIONS: High prevalence of several cardiovascular risk factors in the urban population of a low-income country stresses the need for early public health interventions and adaptation of the health care infrastructure to meet the emerging challenge of cardiovascular disease. The direct SES-BMI association may drive increasing BMI and BP while the population becomes more affluent.     

Changes in prevalence of overweight and in body image among Fijian women between 1989 and 1998

OBJECTIVE: To investigate changes in prevalence of overweight and obesity and in body image among ethnic Fijian women in Fiji during a period of rapid social change and the relationship between changes in body image and BMI. RESEARCH METHODS AND PROCEDURES: The study design was a multiwave cohort study of BMI in a traditional Fijian village over a 9.5-year period from 1989 to 1998. Cohorts were identified in 1989 (n=53) and in 1998 (n=50). Selection criteria included Fijian ethnicity, female gender, age of at least 18 years, and residence in a specific coastal Fijian village in 1989 and 1998, respectively. Assessments consisted of measurement of height and weight, collection of demographic data by written survey, and administration of the Nadroga Language Body Image Questionnaire. RESULTS: The prevalence of overweight and obesity was significantly different between the cohorts, increasing from 60% in 1989 to 84% in 1998 (p=0.014). In addition, the age-adjusted mean BMI was significantly higher in 1998 compared with 1989 (p=0.011). Finally, there were significant between-cohort differences in multiple measures of body image, which were mostly independent of BMI. DISCUSSION: At 84%, the prevalence of overweight and obesity in this community sample of Fijian women is among the highest in the world. The dramatically increased prevalence over the 9.5-year period studied corresponds with rapid social change in Fiji and significant shifts in prevailing traditional attitudes toward body shape.     

Body Mass Index and Blood Pressure among Men of Three Ethnic Groups of Darjeeling,West Bengal,India

This study was undertaken from 2009–2011 to understand the association between body mass index (BMI) and blood pressure (BP) (systolic or SBP and diastolic or DBP) among randomly chosen men, aged 30 to 59 years, of three endogamous communities in Darjeeling, West Bengal, India: Dhimal (n = 88), Mech (n = 71), and Rajbanshi (n = 83). Analysis of variance was applied. Remarkable rates of BMI-based undernutrition (chronic energy deficiency or CED) were recorded among Dhimals (31%) and Rajbanshis (18%). Notable prevalence of overweight (20%) was recorded among men of Mech community. None were found to be obese in three samples. Mean SBP and DBP were found to rise consistently at levels of BMI (undernutrition, normal, and overweight). BMI was observed to rise consistently at levels of blood pressures (normotensive, prehypertensive, and hypertensive). Among Mech, this pattern was found to be more conspicuous. DBP was found to be more sensitive with changes of BMI in men.     

Changes in health-related behaviours and cardiovascular risk factors in young adults: associations with living with a partner

OBJECTIVE: To examine changes in cardiovascular risk factors and health-related behaviours in young Australian adults at a stage of transition from the family environment. STUDY DESIGN: Repeated surveys between 9 and 25 years of age in a community-based group that included 569 eighteen-year-olds and 600 twenty-five-year-olds. RESULTS: There were significant increases (P < 0.001 for all variables) in body mass index (BMI) [men 2.5 kg/m2 (2.0); women 1.7 kg/m2 (2.9)], waist girth [men 7.6 cm (6.5); women 4.3 cm (7.2)], BP (systolic/diastolic) [men 5(12)/7(8) mm Hg; women 3(10)/6(7) mm Hg] and in total cholesterol [men 15% increase; women 9%]. The proportion of sedentary behaviour increased from 19% to 39% in men (P < 0.001) and from 40% to 41% (P = 0.801) in women. Cohabitation was associated with significantly greater increases in BMI, waist circumference, and total cholesterol, associated with dietary change in women and decreased physical activity in men. In mothers, waist girth increased by 8.0 cm (0.1) compared with 3.5 cm (0.6) in women without children (P = 0.003), and physical fitness decreased [-0.5 W/kg (0.4) vs. 1.2 W/kg (0.2), respectively; P = 0.001]. CONCLUSION: Encouragement of a healthy lifestyle, particularly physical activity, should be a priority in this age group, particularly among newly cohabiting couples and in young mothers.     

唐山地区44～64岁城乡居民代谢综合征患病率调查

目的了解唐山地区人群代谢综合征（Ms）的患病状况,并对城市和农村居民MS患病率进行比较。方法采用随机整群抽样方法,于2009年3—4月选取唐山地区44～64岁,平均年龄（54．2~6．9）岁城乡居民共6616人（男2286人,女4330人）进行问卷调查、体格检查及相关代谢指标的测定,采用中华医学会糖尿病学分会诊断标准进行MS筛查。结果唐山市44～64岁居民MS粗患病率、男性及女性粗患病率分别为20．9％,19．5％和21．7％,标化患病率分别为20_3％,19．2％和21．1％。女性MS患病率随年龄的增长而升高（P〈0．叭）,从44～49岁的12．4％增加到60～64岁的30．5％,而男性MS患病率在年龄水平上差异无显著性;城市居民MS患病率（27．8％）高于农村（18．3％,P〈0．01）,农村居民中男性MS患病率（16．7％）低于女性（19．3％,P〈0.05）。MS各组分的检出率依次为超重肥胖（61．4％）、高血压（51．3％）、高三酰甘油（36．6％1和空腹血糖升高（29．0％）。结论唐山地区44—64岁城乡居民标化患病率为20．3％,城市居民MS患病率显著高于农村,超重肥胖和高血压是该地区MS最重要的组成成分。     

Overweight, obesity, and binge eating in a non-clinical sample of five Brazilian cities

OBJECTIVE: To investigate the relationship between obesity/overweight and binge eating episodes (BEEs) in a large nonclinical population. RESEARCH METHODS AND PROCEDURES: Consumers at shopping centers in five Brazilian cities (N = 2858) who participated in an overweight prevention program were interviewed and had weight and height measured to calculate BMI. RESULTS: Prevalence of overweight (BMI = 25 to 29.9 kg/m2) was 46.6% for men and 36.6% for women. Obesity (BMI > or = 30 kg/m2) was about two-thirds of the prevalence of overweight. BEEs (subjects who binged one or more times per week over the last 3 months) in normal-weight individuals was 1.4% for men and 3.9% for women, whereas in overweight/obese, these prevalences were 6.5% and 5.5%, respectively (p < 0.01). After adjustment for age, socioeconomic variables, and childhood obesity, those who reported BEEs had an odds ratio of being overweight/obese of 3.31 (95% confidence interval: 1.11 to 9.85) for men and 1.73 (95% confidence interval: 1.05 to 2.84) for women. DISCUSSION: These findings indicate a strong association between episodes of binge eating and overweight/obesity, mainly among men.     

Major increase in prevalence of overweight and obesity between 1987 and 2001 among Danish adults

OBJECTIVE: The aim of the study was to examine the secular trends in the prevalence of obesity (BMI >or= 30.0 kg/m(2)) and overweight (25.0 相似文献   

Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

BACKGROUND: Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women. METHOD: Nationally representative data on reproductive age women from rural Bangladesh (n = 242,433) and selected urban poor areas (n = 39,749) collected by the Nutritional Surveillance Project during 2000-2004 were analyzed. RESULTS: While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m(2)] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000-2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI > or = 25 kg/m(2), P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be 'at risk of overweight' (BMI 23.0-<25 kg/m(2)). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8-29.3%; rural: 42.6-36.6%), while prevalence of overweight increased (urban poor: 6.8-9.1%; rural: 2.8-5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6-8.7]. Women living in houses of at least 1000 sq ft (93 m(2)) were 3.7 times more likely to be overweight compared with women living in <250 sq ft (23 m(2)) houses (95% CI: 3.2-4.3). CONCLUSION: The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.     

Prevalence of elevated body mass index and blood pressure in a rural school-aged population: implications for school nurses

The growing prevalence of overweight in students and adolescents has become a matter of national concern and is linked to a rise in chronic health conditions in students who previously had low prevalence rates, such as cardiovascular disease. This study examined the relationships between age, ethnicity, race, body mass index (BMI), and elevated blood pressure (BP) in a rural school age population. Data are reported for 1121 students in grades K-11. The sample was 55% African American, 41% Caucasian, 3% Hispanic, and 1% other. The prevalence of students at risk of being overweight (BMI > or =85th percentile) was 46.5%, and the prevalence of overweight students (BMI > or =95th percentile) was 29.1%. The prevalence of elevated BP was 21.6%. Elevated BMI and BP were more prevalent in older students. While there was a direct relationship between elevated BMI and elevated BP for all groups, African Americans were more likely to have an elevated BP with a normal BMI. These findings demonstrate the important role of the school nurse in providing effective prevention strategies related to screening, follow-up, and treatment.     

Nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil: the nutrition, physical activity, and health survey

A household survey was conducted to assess the nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil. In the selected households, all adults (>or= 20 years) had their body mass and stature measured. Body mass index (BMI) was used to determine the nutritional status according to the World Health Organization classification. The population estimates showed low prevalence of underweight (BMI < 18.5kg/m(2)), while 45.8% of women and 49.6% of men were overweight/obese (BMI >or= 25kg/m(2)). Obesity prevalence varied from 5.6% to 19.3% in men and from 9.6% to 21.3% in women, according to age. The prevalence of overweight/obesity was not associated with income (in either men and women) or schooling (in men), but there was an inverse relationship between schooling and overweight/obesity in women. The prevalence of underweight decreased with increasing mean income in the census enumeration area. The authors conclude that overweight/obesity is the most prevalent nutritional disorder in both men and women in Niterói. This pattern resembles recent results for the adult population in Southeast Brazil as a whole, where Niterói is located.     

Effect of Body Weight Changes on Changes in Ambulatory and Standardized Non-Physician Blood Pressures Over Three Years

PURPOSE: This study examines the relationship of changes in body mass index (BMI) to changes in measures of both casual and ambulatory blood pressures over three years.

METHODS: In this prospective study of men aged 30–60 years, a cohort of 198 participants was followed for three years. Height, weight, demographic characteristics, and casual and ambulatory measures of blood pressure (BP) were obtained at baseline and 3-year follow-up.

RESULTS: Change in BMI was significantly associated with change in all ambulatory (awake, work, home, and sleep) and casual systolic and diastolic blood pressures. After controlling for age and race/ethnicity, the association remained significant for nine of the twelve BP change measures. Further tests show that the effect of a change in BMI on BP change does not vary across the six systolic blood pressures or across the six diastolic measures. An average-height man gaining 5 kg (11 pounds) typically exhibited a 2.5 mm Hg increase in systolic and a 1.8 mm Hg increase in diastolic casual and ambulatory BPs. There is no evidence that changes in BP were associated with age, race/ethnicity (blacks vs. Hispanics vs. whites), or the average of the baseline and follow-up levels of BMI. In addition, the impact of weight gain is similar in magnitude, but in the opposite direction, to that of weight loss.

CONCLUSIONS: Changes in BMI over three years predict changes in ambulatory and standardized non-physician BPs. These changes in BP are not related to average BMI level or age.     

Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study

ABSTRACT: BACKGROUND: Childhood obesity and associated hypertension are major public health concerns globally. This study aimed to determine the prevalence of obesity and the associated risk of high blood pressure among Nigerian adolescents. METHODS: A cross-sectional school-based study of 885 apparently healthy adolescents was performed. Weight, height and blood pressure (BP) were measured using standard methods. Body mass index (BMI) was calculated and categorized by age, sex and percentile. Obesity and overweight were defined as: [greater than or equal to] 95th and 85th to < 95th percentiles, respectively, for age, sex and height. Subjects were sub-categorized into age 10-13 years (A) and 14-17 years (B). The odds ratio for pre-hypertensive and hypertensive range BP by age and BMI were generated. Significance was set at P < 0.05. RESULTS: The prevalence of overweight and obesity were 13.8% and 9.4%, respectively. The prevalence of hypertensive range systolic BP and diastolic BP in obese subjects was 16% compared with 2.3% in normal BMI subjects (P = 0.00), and was 12.1% for females versus 6.4% in males (P = 0.27). The prevalence of hypertensive range diastolic BP was 15.2% in obese subjects versus 3.5% in normal subjects (P = 0.01), and 12% in females versus 1.4% in males (P = 0.00). BMI in group B was significantly associated with pre-hypertensive and hypertensive range systolic BP in overweight (P = 0.01, P = 0.002) and obese subjects (P = 0.00, P = 0.00) and with hypertensive range diastolic BP (P = 0.00) only in obese subjects. The only significant association in group A was between obesity and pre-hypertensive range diastolic BP (P = 0.00). CONCLUSION: The prevalence of hypertensive range BP among obese Nigerian adolescents was high. Screening for childhood obesity and hypertension, and long-term follow-up of obese adolescents into adulthood are recommended.