Skip to main content

Advertisement

SpringerLink
Log in

Undernutrition and Obesity Associated with High Blood Pressure in Children and Adolescents from João Pessoa, Paraíba, Brazil

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The objective of this study was to describe the prevalence, correlation, and association of undernutrition and obesity with high blood pressure (HBP). One thousand five hundred seventy (1570) students (808 boys and 762 girls), aged 7–12 years, from João Pessoa, Paraíba (Northeastern Brazil) participated. Measurements of stature, body weight, skinfolds [triceps (TS) and subscapular (SS)], upper-arm circumference (UAC), upper-arm fat area (UAFE), total upper-arm area (TUAA), and BP were taken. Four criteria were adopted to classify undernutrition and obesity. HBP was defined as systolic BP (SBP) and/or diastolic BP (DBP) values ≥90th percentile. Analysis of covariance, Spearman’s correlation, logistic regression, and multiple linear regression were used. In the logistic regression model, undernutrition was not associated with HBP; however, the chances of HBP increased when two or more obesity indicators were present [boys: odds ratio (OR) = 2.08, 95% confidence interval (CI 95%) = 1.26–3.41; girls: OR = 2.26, CI 95% = 1.44–3.55]. In the multiple regression, the BMI, SS, and UAFE explained 15% of the variance of high SBP (r 2 = 0.153) in boys, whereas the body mass index (BMI) and TUAA accounted for 16% of the variance of the SBP (r 2 = 0.166) in girls. The DBP was influenced by the SS in boys (r 2 = 0.022) and the TUAA (r 2 = 0.054) in girls. There was an association between obesity and HBP. The BMI, SS, and UAFE in boys and the BMI and TUAA in girls explained ~16% of elevated SBP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. A measure of development that takes into consideration the gross domestic product (GDP) per capita (adjusted for purchasing power of the country), life expectancy at birth, and education (literacy rate and school enrollment ratio), ranging from 0 to 1.

References

  1. Araújo TL, Lopes MVO, Cavalcante TF, Guedes NG, Moreira RP, Chaves ES et al (2003) Relación entre medidas antropométricas y valores de la presión arterial en estudiantes brasileños. ALAN 56(3):216–223

    Google Scholar 

  2. Barba G, Troiano E, Russo P, Strazzullo P, Siani A (2006) Body mass, fat distribution and blood pressure in Southern Italian children: results of the ARCA project. Nutr Metabol Cardiol Dis 16:239–248

    Article  Google Scholar 

  3. Batista Filho M, Rissin A (2003) A transição nutricional no Brasil: tendências regionais e temporais. Cad Saúde Pública 19(Suppl 1):181–191

    Google Scholar 

  4. Boileau RA (1996) Body composition assessment in children and youth. In: Bar-Or O (ed) The child and adolescent athlete. Blackwell Science, Oxford, pp 523–537

    Google Scholar 

  5. Burke V, Beilin LJ, Dunbar D, Kevan M (2004) Associations between blood pressure and overweight defined by new standards for body mass index in childhood. Prev Med 38:558–564

    Article  PubMed  CAS  Google Scholar 

  6. Cariri Benigna MJ, Dricot J, D’Ans CD (1987) Crescimento e estado nutricional de crianças de 0–11 anos, Estado da Paraíba (nordeste brasileiro). Rev Saúde Pública 21:480–489

    Google Scholar 

  7. Carvalho AT, Costa MJC, Ferreira LOC, Batista Filho M (2000) Cartografia do retardo estatural em escolares do Estado da Paraíba. Brasil Rev Saúde Pública 34(1):3–8

    CAS  Google Scholar 

  8. Cassano PA, Segal MR, Vokonas PS, Weiss ST (1990) Body fat distribution, blood pressure and hypertension. A prospective cohort study of men in the Normative Aging Study. Ann Epidemiol 1:33–48

    Article  PubMed  CAS  Google Scholar 

  9. Christensen K, Støvring H, McGue M (2001) Do genetic factors contribute to the association between birth weight and blood pressure? J Epidemiol Community Health 55:583–587

    Article  PubMed  CAS  Google Scholar 

  10. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 320:1–6

    Article  Google Scholar 

  11. Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007) Body mass index cut offs to define thinness in children and adolescents: international survey. Br Med J 335(7624):831

    Article  Google Scholar 

  12. Costa RS, Sichiere R (1998) Relação entre sobrepeso, adiposidade e distribuição de gordura com a pressão arterial de adolescentes no município do Rio de Janeiro. Rev Bras Epidemiol 1(3):268–279

    Article  Google Scholar 

  13. Field AE, Cook NR, Gillman MW (2005) Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res 13:163–169

    Article  PubMed  Google Scholar 

  14. Francischetti EA, Genelhu VA (2007) Obesity–hypertension: an ongoing pandemic. Int J Clin Pract 61(2):269–280

    Article  PubMed  CAS  Google Scholar 

  15. Frisancho AR (1981) New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 34(11):2540–2545

    PubMed  CAS  Google Scholar 

  16. King DS, Wofford MR (2000) Obesity and hypertension. Drug Topics 144(1):59–69

    Google Scholar 

  17. Lohman TG, Roche AF, Martorell R (1988) Anthropometric standardization reference manual. Human Kinetics Books, Champaign, IL, pp 3–8

    Google Scholar 

  18. Longo-Mbenza B, Lukoki LE, M’Buyamba-Kabangu JR (2007) Nutritional status, socio-economic status, heart rate, and blood pressure in African school children and adolescents. Int J Cardiol 121:171–177

    Article  PubMed  CAS  Google Scholar 

  19. Luiz RR, Magnanini MMF (2000) A lógica da determinação do tamanho da amostra em investigações epidemiológicas. Cad Saúde Coletiva 8(2):9–28

    Google Scholar 

  20. Lurbe E, Alvarez V, Liao Y, Tacons J, Cooper R, Cremades B, Torro I, Redon J (1998) The impact of obesity and body fat distribution on ambulatory blood pressure in children and adolescents. Am J Hypertens 11:418–424

    Article  PubMed  CAS  Google Scholar 

  21. Martínez Vizcaíno V, Aguilar FS, Martínez MS, López SM, Gutiérrez RF, Rodríguez-Artalejo F (2007) Association of adiposity measures with blood lipids and blood pressure in children aged 8–11 years. Acta Paediat 96:1338–1342

    Article  Google Scholar 

  22. McDowell MA, Fryar CD, Hirsch R, Ogden CL (2005) Anthropometric reference data for children and adults: U.S. population, 1999–2002. Advance data from vital and health statistics; 361. National Center for Health Statistics–NCHS, Hyattsville, MD

  23. Mirzaei M, Taylor R, Morrell S, Leeder SR (2007) Predictors of blood pressure in a cohort of school-aged children. Eur J Cardiovasc Prev Rehabil 14(5):624–629

    Article  PubMed  Google Scholar 

  24. Monego ET, Brandão PC, Jardim V (2006) Determinantes de Risco para Doenças Cardiovasculares em Escolares. Arq Bras Cardiol 87(1):37–45

    Article  PubMed  Google Scholar 

  25. Monteiro CA, D’Aquino Benicio MH, Iunes R, Gouveia NC, Taddei JAAC, Cardoso MAA (1993) ENDEF and PNSN: trends in physical growth of brazilian children. Cad Saúde Pública 9(Suppl 1):85–95

    PubMed  Google Scholar 

  26. Must A, Spadano J, Coakley EH (1999) The disease burden associated with overweight and obesity. JAMA 282:1523–1529

    Article  PubMed  CAS  Google Scholar 

  27. National high blood pressure education program working group on hypertension control in children, adolescents–NHBPEP (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  28. Norton K, Olds T (2005) Erros de medição em antropometria. In Antropométrica/Pederson D & Gore C. Trad. por Nilda Maria F. de Albernaz – Porto Alegre, Artmed, pp 89–104

  29. World Health Organization – WHO (2005) Preventing chronic diseases: a vital investment: WHO global report. http://www.who.int/chp/chronic_disease_report/en/

  30. Peixoto MRG, Benício MHD, Latorre MRDO, Jardim PCBV (2006) Waist circumference and body mass index as predictors of hypertension. Arq Bras Cardiol 87:416–423

    Article  Google Scholar 

  31. Pesquisa de Orçamentos Familiares 2002–2003 (2006) Antropometria e análise do estado nutricional de crianças e adolescentes no Brasil. Instituto Brasileiro de Geografia e Estatística (IBGE), Rio de Janeiro

  32. Programa das Nações Unidas para o Desenvolvimento–PNUD (2003) Atlas de Desenvolvimento Humano no Brasil. Disponível em www.pnud.org.br, acessado em 05/09/2007

  33. Rao S, Kanade A, Kelkar R (2007) Blood pressure among overweight adolescents from urban school children in Pure, India. Eur J Clin Nutr 61:633–641

    PubMed  CAS  Google Scholar 

  34. Ribeiro RQC, Lotufo PA, Lamounier JA, Oliveira RG, Soares JF, Botter DA (2006) Fatores Adicionais de Risco Cardiovascular Associados ao Excesso de Peso em Crianças e Adolescentes. O Estudo do Coração de Belo Horizonte. Arq Bras Cardiol 86(6):408–418

    Article  PubMed  Google Scholar 

  35. Rolland-Cachera MF, Brambilla P, Manzoni P, Akrout M, Sironi S, Maschio AD et al (1997) Body composition assessed on the basis of arm circumference and triceps skinfold thickness: a new index validated in children by magnetic resonance imaging. Am J Clin Nutr 65:1709–1913

    PubMed  CAS  Google Scholar 

  36. Rosa MLG, Fonseca VM, Oigman G, Mesquita ET (2006) Pré-Hipertensão Arterial e Pressão de Pulso Aumentada em Adolescentes: Prevalência e Fatores Associados. Arq Bras Cardiol 87(1):46–53

    Article  PubMed  Google Scholar 

  37. Rosa MLG, Mesquita ET, Rocha ERR, Fonseca VM (2007) Índice de Massa Corporal e Circunferência da Cintura como Marcadores de Hipertensão Arterial em Adolescentes. Arq Bras Cardiol 88(5):573–578

    Article  PubMed  Google Scholar 

  38. Sarno F, Monteiro CA (2007) Importância relativa do Índice de Massa Corporal e da circunferência abdominal na predição da hipertensão arterial. Rev Saúde Pública 41(5):788–796

    Article  PubMed  Google Scholar 

  39. Sesso R, Barreto GP, Neves J, Sawaya AL (2004) Malnutrition is associated with increased blood pressure in childhood. Nephron Clin Pract 97:61–66

    Article  Google Scholar 

  40. Weiss R, Dziura J, Burgert TS (2004) Obesity and metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374

    Article  PubMed  CAS  Google Scholar 

  41. Williams DP, Going SB, Lohman TG, Harsha DW, Srinivasan SR, Webber LS et al (1992) Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein rations in children and adolescents. Am J Public Health 82:358–363

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. R. Cônego João de Deus, 145 – Castelo Branco I, João Pessoa, PB, CEP 58050-360, Brazil

    Kelly S. Silva

  2. Federal University of Paraíba, João Pessoa, PB, Brazil

    Kelly S. Silva

  3. Federal University of Santa Catarina, Florianopolis, SC, Brazil

    Rosane C. R. Silva, Maria F. S. Duarte & Adair S. Lopes

  4. Catholic University of Brasília, Brasilia, DF, Brazil

    Francisco M. Silva

Authors
  1. Kelly S. Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosane C. R. Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria F. S. Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adair S. Lopes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francisco M. Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kelly S. Silva.

Additional information

K. S. Silva participated in the data collection, the structuring and elaboration of the manuscript; M. F. S. Duarte, R. C. R. Silva, A. S. Lopes, and F. M. Silva participated in the elaboration and critical analysis of the article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silva, K.S., Silva, R.C.R., Duarte, M.F.S. et al. Undernutrition and Obesity Associated with High Blood Pressure in Children and Adolescents from João Pessoa, Paraíba, Brazil. Pediatr Cardiol 30, 248–255 (2009). https://doi.org/10.1007/s00246-008-9326-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-008-9326-9

Keywords

Search

Navigation