[Hypertension in obese children and adolescents]

The frequency of arterial hypertension (AHT) in children is around 3.2-4.5% nowadays, however 3-4 decades ago it was below 1.5%. In obese children AHT is 3-5 times more frequent than in lean children.

Retrospective evaluation of frequency of AHT and metabolic complications in obese children and adolescents.

One hundred seventy children and adolescents (100 girls) at the mean age of 14.6 years (range: 10-18 years) diagnosed with simple obesity admitted to The Department of Pediatric and Adolescent Endocrinology in Krakow, Poland were assessed in the study. Patients were divided into three groups: 1- obese normotensive (n=43), 2- obese prehypertensive (n=31), 3- obese hypertensive (n=96). Blood pressure (BP) was assessed by Korotkow method. The result was expressed as a mean of 3 independent BP measurements. Biochemical analysis included oral glucose tolerance test with assessments of glucose, insulin and HOMA-IR (the homeostatic index for insulin resistance) as well as lipid profile and uric acid measurements.

AHT was found in 96 patients (55.8%), in 53 girls (52%) and 43 boys (61.4%). Prehypertensive values of BP were found in 31 patients (18 girls). Systolic AHT was found in 90 patients (52.9%), diastolic AHT in 56 patients (32.9%), and both systolic and diastolic AHT in 50 patients (29.4%). In group 3. BMI was higher than in group 1. BMI correlated significantly with systolic and diastolic BP. Uric acid levels were higher in group 3. than in group 1., and higher in patients with diastolic AHT. Basal insulin levels were higher in diastolic AHT patients and poststimulatory insulin was higher in systolic AHT patients. HOMA-IR was higher in patients with diastolic AHT than in patients with normal diastolic BP. Lipid profile did not differ between the groups, however the highest percentage of patients with abnormal lipid profile was found in group 2.

An early endocrine referral in pediatric obese patients is advisable to monitor complications of obesity.