Home The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou
Article
Licensed
Unlicensed Requires Authentication

The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou

  • Cailong Chen , Menglan Lu , Ying Wu , Zheng Zhang , Jia Hu , Jieyun Yin , Wanping Zhou , Jia-Ying Xu , Haitao Lv EMAIL logo and Li-Qiang Qin EMAIL logo
Published/Copyright: December 21, 2021
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 35 Issue 3

Abstract

Objectives

Lifestyle changes have led to an increase in the prevalence of hypertension in Chinese children and adolescents. The aim of this study was to analyze the prevalence of hypertension and its association with overweight and obesity among students aged 6–17 years in Suzhou. This retrospective analysis included physical examination data of primary and junior high school students in Suzhou Industrial Park from 2016 to 2019.

Methods

Elevated blood pressure and hypertension were defined using blood pressure criteria appropriate for age, sex, and height percentile. Overweight and obesity were defined using the 2007 diagnostic criteria proposed by the World Health Organization for school-age children. Logistic regression analysis was used to evaluate the association between hypertension and overweight and obesity.

Results

A total of 128,113 students were included. The prevalence of elevated BP and hypertension was 9.92% and 13.56%, respectively. The incidence of high blood pressure was higher in boys than in girls and increased with an increase in body mass index (BMI). The prevalence of hypertension in obese boys and girls (27.07% and 27.49%, respectively) was 2.3-fold and 2.8-fold higher than that in normal-weight boys and girls (11.58% and 9.83%, respectively).

Conclusions

Blood pressure was positively correlated with BMI, and the risk of high blood pressure due to overweight/obesity was 10.44%. Overweight and obesity significantly increased the risk of hypertension in students aged 6–17 years in Suzhou. Targeted weight-loss programs during childhood and adolescence may reduce the risk of hypertension in adulthood.

Keywords: adolescent; child; elevated blood pressure; hypertension; obesity; overweight
Corresponding authors: Professor Li-Qiang Qin, Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, NO.199, Renai Road, Suzhou 215123, Jiangsu Province, China, E-mail: ; and Professor Haitao Lv, Children Health Management Center, Children’s Hospital of Soochow University, NO. 92, Zhongnan Street, Suzhou 215025, Jiangsu Province, China, E-mail:

Acknowledgments

We would like to thank all our students and families who contributed to this survey. We greatly appreciate the support of Liqiang Qin and Haitao Lv who support us throughout this project.

  1. Research funding: None declared.

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The ethics committee of the Children’s Hospital of Soochow University approved this study and waived the requirement for consent because the analysis was retrospective and anonymized.

References

1. Song, P, Zhang, Y, Yu, J, Zha, M, Zhu, Y, Rahimi, K, et al.. Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr 2019;173:1–10, https://doi.org/10.1001/jamapediatrics.2019.3310.Search in Google Scholar PubMed PubMed Central

2. Lee, CG. The emerging epidemic of hypertension in Asian children and adolescents. Curr Hypertens Rep 2014;16:495, https://doi.org/10.1007/s11906-014-0495-z.Search in Google Scholar PubMed

3. Tian, C, Xu, S, Wang, H, Wang, W, Shen, H. Prevalence of pre-high blood pressure and high blood pressure among non-overweight children and adolescents using international blood pressure references in developed regions in China. Ann Hum Biol 2017;44:574–7, https://doi.org/10.1080/03014460.2017.1318952.Search in Google Scholar PubMed

4. Gupta-Malhotra, M, Banker, A, Shete, S, Hashmi, SS, Tyson, JE, Barratt, MS, et al.. Essential hypertension vs. secondary hypertension among children. Am J Hypertens 2015;28:73–80, https://doi.org/10.1093/ajh/hpu083.Search in Google Scholar PubMed PubMed Central

5. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114: 555–76.10.1542/peds.114.S2.555Search in Google Scholar

6. Toschke, AM, Kohl, L, Mansmann, U, von Kries, R. Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials. Acta Paediatr 2010;99:24–9, https://doi.org/10.1111/j.1651-2227.2009.01544.x.Search in Google Scholar PubMed

7. Kelly, RK, Thomson, R, Smith, KJ, Dwyer, T, Venn, A, Magnussen, CG. Factors affecting tracking of blood pressure from childhood to adulthood: the childhood determinants of adult health study. J Pediatr 2015;167:1422–8.e2, https://doi.org/10.1016/j.jpeds.2015.07.055.Search in Google Scholar PubMed

8. Chen, X, Wang, Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis. Circulation 2008;117:3171–80, https://doi.org/10.1161/circulationaha.107.730366.Search in Google Scholar

9. Kannel, WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. J Am Med Assoc 1996;275:1571–6, https://doi.org/10.1001/jama.1996.03530440051036.Search in Google Scholar

10. Lamotte, C, Iliescu, C, Libersa, C, Gottrand, F. Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr 2011;170:719–29, https://doi.org/10.1007/s00431-010-1328-y.Search in Google Scholar PubMed

11. Rao, G. Diagnosis, epidemiology, and management of hypertension in children. Pediatrics 2016;138:e20153616, https://doi.org/10.1542/peds.2015-3616.Search in Google Scholar PubMed

12. Xi, B, Liang, Y, Mi, J. Hypertension trends in Chinese children in the national surveys, 1993 to 2009. Int J Cardiol 2013;165:577–9, https://doi.org/10.1016/j.ijcard.2012.09.032.Search in Google Scholar PubMed

13. Dong, B, Ma, J, Wang, HJ, Wang, ZQ. The association of overweight and obesity with blood pressure among Chinese children and adolescents. Biomed Environ Sci 2013;26:437–44, https://doi.org/10.3967/0895-3988.2013.06.004.Search in Google Scholar PubMed

14. Wang, S, Dong, YH, Wang, ZH, Zou, ZY, Ma, J. Trends in overweight and obesity among Chinese children of 7–18 years old during 1985–2014. Zhonghua Yu Fang Yi Xue Za Zhi 2017;51:300–5, https://doi.org/10.3760/cma.j.issn.0253-9624.2017.04.005.Search in Google Scholar PubMed

15. DeMarco, VG, Aroor, AR, Sowers, JR. The pathophysiology of hypertension in patients with obesity. Nat Rev Endocrinol 2014;10:364–76, https://doi.org/10.1038/nrendo.2014.44.Search in Google Scholar PubMed PubMed Central

16. Seravalle, G, Grassi, G. Obesity and hypertension. Pharmacol Res 2017;122:1–7, https://doi.org/10.1016/j.phrs.2017.05.013.Search in Google Scholar PubMed

17. Hu, J, Shen, H, Wu, JZ, Xiao, Q, Chu, GP, Teng, CG, et al.. Prevalence of high blood pressure and high normal blood pressure among 7- to 17-year-old children and adolescents in developed regions, China from 2014 to 2017: using new national blood pressure reference for Chinese children and adolescents. J Hum Hypertens 2019;33:400–10, https://doi.org/10.1038/s41371-019-0183-1.Search in Google Scholar PubMed

18. de Onis, M, Lobstein, T. Defining obesity risk status in the general childhood population: which cut-offs should we use? Int J Pediatr Obes 2010;5:458–60, https://doi.org/10.3109/17477161003615583.Search in Google Scholar PubMed

19. Xi, B, Zong, X, Kelishadi, R, Hong, YM, Khadilkar, A, Steffen, LM, et al.. International child blood pressure references establishment consortium. Establishing international blood pressure references among nonoverweight children and adolescents aged 6–17 years. Circulation 2016;133:398–408, https://doi.org/10.1161/circulationaha.115.017936.Search in Google Scholar PubMed PubMed Central

20. Cote, AT, Harris, KC, Panagiotopoulos, C, Sandor, GG, Devlin, AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol 2013;62:1309–19, https://doi.org/10.1016/j.jacc.2013.07.042.Search in Google Scholar PubMed

21. Lima, TR, González-Chica, DA, Moreno, YMF, Silva, DAS. Healthy lifestyle moderates the relationship between cardiovascular disease with blood pressure, body composition, carotid intima-media thickness, and glycated hemoglobin among adults. Appl Physiol Nutr Metabol 2020;45:539–46, https://doi.org/10.1139/apnm-2019-0515.Search in Google Scholar

22. Li, B, Pallan, M, Liu, WJ, Hemming, K, Frew, E, Lin, R, et al.. The CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school--aged children: a cluster-randomised controlled trial. PLoS Med 2019;16:e1002971, https://doi.org/10.1371/journal.pmed.1002971.Search in Google Scholar

23. Dong, Y, Jan, C, Ma, Y, Dong, B, Zou, Z, Yang, Y, et al.. Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys. Lancet Diabetes Endocrinol 2019;7:288–99, https://doi.org/10.1016/s2213-8587(19)30075-0.Search in Google Scholar

24. Flores, PJ, Cruz, AJ, Gascón, MB. Insatisfacción con la imagen corporal en niños y adolescentes: revisión sistemática [Body-image dissatisfaction in children and adolescents: a systematic review]. Nutr Hosp 2017;34:479–89, https://doi.org/10.20960/nh.455.Search in Google Scholar PubMed

25. Zhang, YX, Wang, SR. Comparison of blood pressure levels among children and adolescents with different body mass index and waist circumference: study in a large sample in Shandong, China. Eur J Nutr 2014;53:627–34, https://doi.org/10.1007/s00394-013-0571-1.Search in Google Scholar PubMed

26. Lu, X, Shi, P, Luo, CY, Zhou, YF, Yu, HT, Guo, CY, et al.. Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai, China. BMC Publ Health 2013;13:24, https://doi.org/10.1186/1471-2458-13-24.Search in Google Scholar PubMed PubMed Central

27. Zhao, 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;7:16895, https://doi.org/10.1038/s41598-017-16819-y.Search in Google Scholar PubMed PubMed Central

28. Hardy, ST, Sakhuja, S, Jaeger, BC, Urbina, EM, Suglia, SF, Feig, DI, et al.. Trends in blood pressure and hypertension among US children and adolescents, 1999–2018. JAMA Netw Open 2021;4:e213917, https://doi.org/10.1001/jamanetworkopen.2021.3917.Search in Google Scholar PubMed PubMed Central

29. Cho, H, Kim, JH. Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea national health and nutrition examination survey 2007–2015. J Clin Hypertens 2020;22:590–7, https://doi.org/10.1111/jch.13842.Search in Google Scholar PubMed PubMed Central

30. Lu, X, Shi, P, Luo, CY, Zhou, YF, Yu, HT, Guo, CY, et al.. Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai, China. BMC Publ Health 2013;13:24, https://doi.org/10.1186/1471-2458-13-24.Search in Google Scholar

31. Zhang, YX, Wang, ZX, Zhao, JS, Chu, ZH. Profiles of blood pressure among children and adolescents categorized by BMI and waist circumference. Blood Pres Monit 2016;21:295–300, https://doi.org/10.1097/mbp.0000000000000203.Search in Google Scholar

32. Wang, J, Zhu, Y, Jing, J, Chen, Y, Mai, J, Wong, SH, et al.. Relationship of BMI to the incidence of hypertension: a 4 years’ cohort study among children in Guangzhou, 2007–2011. BMC Publ Health 2015;15:782, https://doi.org/10.1186/s12889-015-1997-6.Search in Google Scholar PubMed PubMed Central

33. Meena, J, Singh, M, Agarwal, A, Chauhan, A, Jaiswal, N. Prevalence of hypertension among children and adolescents in India: a systematic review and meta-analysis. Indian J Pediatr 2021;88:1107–14. https://doi.org/10.1007/s12098-021-03686-9.Search in Google Scholar PubMed

Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2021-0033).

Received: 2021-01-16
Revised: 2021-12-01
Accepted: 2021-12-01
Published Online: 2021-12-21
Published in Print: 2022-03-28

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review Article
  3. Congenital hyperinsulinism: recent updates on molecular mechanisms, diagnosis and management
  4. Original Articles
  5. Weight changes of children in 1 year during COVID-19 pandemic
  6. Three novel mutations of the BCKDHA, BCKDHB and DBT genes in Chinese children with maple syrup urine disease
  7. Rates of adrenal insufficiency using a monoclonal vs. polyclonal cortisol assay
  8. Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis
  9. Identification of three novel pathogenic mutations in cystathionine beta-synthase gene of Pakistani intellectually disabled patients
  10. The prevalence of incidental finding of gynecomastia on thoracic computed tomography in the pediatric age group
  11. The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou
  12. Investigation of androgen receptor gene CAG repeat length polymorphism in pubertal gynecomastia
  13. A single-centre study of genetic mutations, audiology, echocardiogram and pulmonary function in Saudi children with osteogenesis imperfecta
  14. A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts
  15. Clinical, pathological and molecular spectrum of patients with glycogen storage diseases in Pakistan
  16. Allelic dropout in PAH affecting the results of genetic diagnosis in phenylketonuria
  17. Short Communication
  18. Role of the SARS-CoV-2 virus in the appearance of new onset type 1 diabetes mellitus in children in Gran Canaria, Spain
  19. Case Reports
  20. 3-M syndrome – a primordial short stature disorder with novel CUL7 mutation in two Indian patients
  21. The coincidence of two rare diseases with opposite metabolic phenotype: a child with congenital hyperinsulinism and Bloom syndrome
  22. Growth hormone deficiency in a child with benign hereditary chorea caused by a de novo mutation of the TITF1/NKX2-1 gene
  23. Identification of a novel mutation in the PHKA2 gene in a child with liver cirrhosis
https://doi.org/10.1515/jpem-2021-0033
Keywords for this article
adolescent; child; elevated blood pressure; hypertension; obesity; overweight

Articles in the same Issue

  1. Frontmatter
  2. Review Article
  3. Congenital hyperinsulinism: recent updates on molecular mechanisms, diagnosis and management
  4. Original Articles
  5. Weight changes of children in 1 year during COVID-19 pandemic
  6. Three novel mutations of the BCKDHA, BCKDHB and DBT genes in Chinese children with maple syrup urine disease
  7. Rates of adrenal insufficiency using a monoclonal vs. polyclonal cortisol assay
  8. Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis
  9. Identification of three novel pathogenic mutations in cystathionine beta-synthase gene of Pakistani intellectually disabled patients
  10. The prevalence of incidental finding of gynecomastia on thoracic computed tomography in the pediatric age group
  11. The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6–17 years in Suzhou
  12. Investigation of androgen receptor gene CAG repeat length polymorphism in pubertal gynecomastia
  13. A single-centre study of genetic mutations, audiology, echocardiogram and pulmonary function in Saudi children with osteogenesis imperfecta
  14. A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts
  15. Clinical, pathological and molecular spectrum of patients with glycogen storage diseases in Pakistan
  16. Allelic dropout in PAH affecting the results of genetic diagnosis in phenylketonuria
  17. Short Communication
  18. Role of the SARS-CoV-2 virus in the appearance of new onset type 1 diabetes mellitus in children in Gran Canaria, Spain
  19. Case Reports
  20. 3-M syndrome – a primordial short stature disorder with novel CUL7 mutation in two Indian patients
  21. The coincidence of two rare diseases with opposite metabolic phenotype: a child with congenital hyperinsulinism and Bloom syndrome
  22. Growth hormone deficiency in a child with benign hereditary chorea caused by a de novo mutation of the TITF1/NKX2-1 gene
  23. Identification of a novel mutation in the PHKA2 gene in a child with liver cirrhosis
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 8.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2021-0033/html
Scroll to top button