Childhood Obesity, Arterial Stiffness, and Prevalence and Treatment of Hypertension

Current Treatment Options in Cardiovascular Medicine

Volumn 16, Issue 11, 2014, Pages 1-14

  Armstrong, Kathryn R ^a   Cote, Anita T ^b   Devlin, Angela M ^b   Harris, Kevin C ^a,b  

^a BC CHILDREN S HOSPITAL   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Arterial stiffness; Childhood obesity; Hypertension; Treatment

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIHYPERTENSIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR;

ARTERIAL STIFFNESS; CARDIOVASCULAR DISEASE; CHILDHOOD OBESITY; CLINICAL EVALUATION; DISEASE ASSOCIATION; ELEVATED BLOOD PRESSURE; EXERCISE; HUMAN; HYPERTENSION; LIFESTYLE MODIFICATION; PATHOPHYSIOLOGY; PREVALENCE; PRIMARY PREVENTION; REVIEW; RISK FACTOR; VASCULAR DISEASE;

EID: 84933520025     PISSN: 10928464     EISSN: 15343189     Source Type: Journal    
DOI: 10.1007/s11936-014-0339-9     Document Type: Review

References (89)

1. Abraham S, Collins G, Nordsieck M. Relationship of childhood weight status to morbidity in adults. HSMHA Health Rep. 1971;86(3):273–84.
2. Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002;40(4):441–7.
3. Garell DC. The obese person as an adolescent. Calif Med. 1967;106(5):368–71.
4. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307(5):483–90.
5. Skinner AC, JA Skelton. Prevalence and Trends in Obesity and Severe Obesity Among Children in the United States, 1999–2012. JAMA Pediatr, 2014. This review provides the most recent prevalence of childhood obesity in the USA population, sampling data from 26 690 children over 14 years (1999–2012). The survey reveals that while obesity prevalence has increased during this time, more recent years show a levelling off, with the exception of an upward trend of more severe forms of obesity. This paper highlights the need for further studies addressing the factors impacting both positive and negative trends.
6. Services, U.S.D.o.H.a.H. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics, 2004; 114(2 Suppl 4th Report): p. 555–76.
7. Bucher BS, Ferrarini A, Weber N, Bullo M, Bianchetti MG, Simonetti GD. Primary hypertension in childhood. Curr Hypertens Rep. 2013;15(5):444–52.
8. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.
9. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–e292.
10. Rosner B, Cook NR, Daniels S, Falkner B. Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988–2008. Hypertension. 2013;62(2):247–54.
11. Shi Y, de Groh M, Morrison H. Increasing blood pressure and its associated factors in Canadian children and adolescents from the Canadian Health Measures Survey. BMC Public Health. 2012;12(1):388.
12. Herouvi D, Karanasios E, Karayianni C, Karavanaki K. Cardiovascular disease in childhood: the role of obesity. Eur J Pediatr. 2013;172(6):721–32.
13. Spagnolo A, Giussani M, Ambruzzi AM, Bianchetti M, Maringhini S, Matteucci MC, et al. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents. Ital J Pediatr. 2013;39:20.
14. Feber J, Ahmed M. Hypertension in children: new trends and challenges. Clin Sci (Lond). 2010;119(4):151–61.
15. Ostchega Y, Carroll M, Prineas RJ, McDowell MA, Louis T, Tilert T. Trends of elevated blood pressure among children and adolescents: data from the National Health and Nutrition Examination Survey 1988–2006. Am J Hypertens. 2009;22(1):59–67.
16. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298(8):874–9.
17. Yang Q, Zhang Z, Kuklina EV, Fang J, Ayala C, Hong Y, et al. Sodium intake and blood pressure among US children and adolescents. Pediatrics. 2012;130(4):611–9.
18. Chen JL, Wu Y. Cardiovascular risk factors in Chinese American children: associations between overweight, acculturation, and physical activity. J Pediatr Health Care. 2008;22(2):103–10.
19. Kaess BM, Rong J, Larson MG, Hamburg NM, Vita JA, Levy D, et al. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA. 2012;308(9):875–81.
20. Li Y, Yang X, Zhai F, Piao J, Zhao W, Zhang J, et al. Childhood obesity and its health consequence in China. Obes Rev. 2008;9 Suppl 1:82–6.
21. Strufaldi MW, Silva EM, Franco MC, Puccini RF. Blood pressure levels in childhood: probing the relative importance of birth weight and current size. Eur J Pediatr. 2009;168(5):619–24.
22. Juonala M, Viikari JS, Raitakari OT. Main findings from the prospective Cardiovascular Risk in Young Finns Study. Curr Opin Lipidol. 2013;24(1):57–64.
23. Hanevold C, Waller J, Daniels S, Portman R, Sorof J. The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics. 2004;113(2):328–33.
24. Litwin M, Niemirska A, Sladowska J, Antoniewicz J, Daszkowska J, Wierzbicka A, et al. Left ventricular hypertrophy and arterial wall thickening in children with essential hypertension. Pediatr Nephrol. 2006;21(6):811–9.
25. Koskinen J, Kahonen M, Viikari JS, Taittonen L, Laitinen T, Ronnemaa T, et al. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation. 2009;120(3):229–36.
26. Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.
27. Wilkinson IB, McEniery CM, Cockcroft JR. Arteriosclerosis and atherosclerosis: guilty by association. Hypertension. 2009;54(6):1213–5.
28. Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011;57(14):1511–22.
29. Cote AT, Harris KC, Panagiotopoulos C, Sandor GG, Devlin AM. Childhood Obesity and Cardiovascular Dysfunction. J Am Coll Cardiol. 2013;62(15):1309–19.
30. Aggoun Y, Szezepanski I, Bonnet D. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events in children. Pediatr Res. 2005;58(2):173–8.
31. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588–605.
32. Adji A, O'Rourke MF, Namasivayam M. Arterial stiffness, its assessment, prognostic value, and implications for treatment. Am J Hypertens. 2011;24(1):5–17.
33. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27. This study was the first to show arterial stiffness, measured as aortic pulse wave velocity, is a strong predictor of future CV events and all-cause mortality. This meta-analysis also found the predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk. This highlights the importance of early identification and intervention.
34. Koopman LP, McCrindle BW, Slorach C, Chahal N, Hui W, Sarkola T, et al. Interaction between myocardial and vascular changes in obese children: a pilot study. J Am Soc Echocardiogr. 2012;25(4):401–410 e1.
35. Nunez F, Martinez-Costa C, Sanchez-Zahonero J, Morata J, Chorro FJ, Brines J. Carotid artery stiffness as an early marker of vascular lesions in children and adolescents with cardiovascular risk factors. Rev Esp Cardiol. 2010;63(11):1253–60.
36. Pandit D, Kinare A, Chiplonkar S, Khadilkar A, Khadilkar V. Carotid arterial stiffness in overweight and obese Indian children. J Pediatr Endocrinol Metab. 2011;24(1–2):97–102.
37. Celik A, Ozcetin M, Yerli Y, Damar IH, Kadi H, Koc F, et al. Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars. 2011;39(7):557–62.
38. Harris KC, Al Saloos HA, De Souza AM, Sanatani S, Hinchliffe M, Potts JE, et al. Biophysical properties of the aorta and left ventricle and exercise capacity in obese children. Am J Cardiol. 2012;110(6):897–901.
39. Urbina EM, Kimball TR, Khoury PR, Daniels SR, Dolan LM. Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus. J Hypertens. 2010;28(8):1692–8.
40. Pierce GL, Zhu H, Darracott K, Edet I, Bhagatwala J, Huang Y, et al. Arterial stiffness and pulse-pressure amplification in overweight/obese African-American adolescents: relation with higher systolic and pulse pressure. Am J Hypertens. 2013;26(1):20–6.
41. Jin Y, Chen Y, Tang Q, Xue M, Li W, Jiang J. Evaluation of carotid artery stiffness in obese children using ultrasound radiofrequency data technology. J Ultrasound Med. 2013;32(1):105–13.
42. Iwashima S, Nakagawa Y, Ishikawa T, Satake SS, Nagata E, Ohzeki T. Abdominal obesity is associated with cardiovascular risk in Japanese children and adolescents. J Pediatr Endocrinol Metab. 2011;24(1–2):51–4.
43. Polat TB, Urganci N, Caliskan KC, Akyildiz B. Correlation of abdominal fat accumulation and stiffness of the abdominal aorta in obese children. J Pediatr Endocrinol Metab. 2008;21(11):1031–40.
44. Pac FA, Guray Y, Polat TB. Wall motion velocities of ascending aorta measured by tissue Doppler imaging in obese children. Pediatr Int. 2010;52(5):778–84.
45. Ozcetin M, Celikyay ZR, Celik A, Yilmaz R, Yerli Y, Erkorkmaz U. The importance of carotid artery stiffness and increased intima-media thickness in obese children. S Afr Med J. 2012;102(5):295–9.
46. Sakuragi S, Abhayaratna K, Gravenmaker KJ, O'Reill C, Srikusalanukul W, Budge MM, et al. Influence of adiposity and physical activity on arterial stiffness in healthy children: the lifestyle of our kids study. Hypertension. 2009;53(4):611–6. This investigation found BMI, waist circumference, and percentage of body fat, were all independently and positively associated with PWV (after adjusting for age, sex, and BP, P < 0.01 for all). This work highlights the effects of excess adiposity on arterial stiffening in healthy prepubescent children.
47. Niboshi A, Hamaoka K, Sakata K, Inoue F. Characteristics of brachial-ankle pulse wave velocity in Japanese children. Eur J Pediatr. 2006;165(9):625–9.
48. Dangardt F, Osika W, Volkmann R, Gan LM, Friberg P. Obese children show increased intimal wall thickness and decreased pulse wave velocity. Clin Physiol Funct Imaging. 2008;28(5):287–93.
49. Lurbe E, Torro I, Garcia-Vicent C, Alvarez J, Fernandez-Fornoso JA, Redon J. Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertension. 2012;60(2):550–5.
50. Charakida M, Jones A, Falaschetti E, Khan T, Finer N, Sattar N, et al. Childhood obesity and vascular phenotypes: a population study. J Am Coll Cardiol. 2012;60(25):2643–50.
51. Dangardt F, Chen Y, Berggren K, Osika W, Friberg P. Increased rate of arterial stiffening with obesity in adolescents: a five-year follow-up study. PLoS One. 2013;8(2):e57454. After initial testing did not reveal an impairment in PWV in children with obesity compared with controls, five years later in late adolescence, arterial stiffness was increased in obese youth. The increase in PWV and DBP was associated with baseline BMI z-score suggesting that obesity is a risk factor for arterial stiffness and hypertension, but the exact time-course of these developments is not known.
52. Lee HY, Oh BH. Aging and arterial stiffness. Circ J. 2010;74(11):2257–62.
53. Sung J, Choi SH, Choi YH, Kim DK, Park WH. The relationship between arterial stiffness and increase in blood pressure during exercise in normotensive persons. J Hypertens. 2012;30(3):587–91.
54. Dernellis J, Panaretou M. Aortic stiffness is an independent predictor of progression to hypertension in nonhypertensive subjects. Hypertension. 2005;45(3):426–31.
55. Najjar SS, Scuteri A, Shetty V, Wright JG, Muller DC, Fleg JL, et al. Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore Longitudinal Study of Aging. J Am Coll Cardiol. 2008;51(14):1377–83.
56. Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959–71.
57. Dias RG, Gowdak MM, Pereira AC. Genetics and cardiovascular system: influence of human genetic variants on vascular function. Genes Nutr. 2011;6(1):55–62.
58. Franklin SS. Arterial stiffness and hypertension: a two-way street? Hypertension. 2005;45(3):349–51.
59. 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):1719–42.
60. Assadi F. The growing epidemic of hypertension among children and adolescents: a challenging road ahead. Pediatr Cardiol. 2012;33(7):1013–20.
61. Juhola J, Oikonen M, Magnussen CG, Mikkila V, Siitonen N, Jokinen E, et al. Childhood physical, environmental, and genetic predictors of adult hypertension: the cardiovascular risk in young Finns study. Circulation. 2012;126(4):402–9.
62. Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res. 2005;13(1):163–9.
63. Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ. 2012;345:e4759.
64. Kuczmanski R, Ogden C, Grummer-Strawn L, Flegal K, Guo S, Wei R, et al. CDC Growth Charts: United States, in Advanced data from vital and health statistics; no. 3142000, National Centre for Health Statistics: Hyattsville, MD.
65. Hofman A, Valkenburg HA, Maas J, Groustra FN. The natural history of blood pressure in childhood. Int J Epidemiol. 1985;14(1):91–6.
66. Malcolm DD, Burns TL, Mahoney LT, Lauer RM. Factors affecting left ventricular mass in childhood: the Muscatine Study. Pediatrics. 1993;92(5):703–9.
67. Kavey RE. Left ventricular hypertrophy in hypertensive children and adolescents: predictors and prevalence. Curr Hypertens Rep. 2013;15(5):453–7.
68. de Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitiis O, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol. 1992;20(5):1251–60.
69. Seeman T, Pohl M, Palyzova D, John U. Microalbuminuria in children with primary and white-coat hypertension. Pediatr Nephrol. 2012;27(3):461–7.
70. Willi SM, Hirst K, Jago R, Buse J, Kaufman F, El Ghormli L, et al. Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial. Pediatr Obes. 2012;7(3):230–9. This paper highlights the importance of changing school environment with regards to nutrition and physical activity and demonstrates the importance of education and positive reinforcement to decrease levels of hypertension in the teenage population.
71. Mikkila V, Rasanen L, Laaksonen MM, Juonala M, Viikari J, Pietinen P, et al. Long-term dietary patterns and carotid artery intima media thickness: the Cardiovascular Risk in Young Finns Study. Br J Nutr. 2009;102(10):1507–12.
72. Shay CM, Ning H, Daniels SR, Rooks CR, Gidding SS, Lloyd-Jones DM. Status of cardiovascular health in US adolescents: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005–2010. Circulation. 2013;127(13):1369–76.
73. Couch SC, Saelens BE, Levin L, Dart K, Falciglia G, Daniels SR. The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. J Pediatr. 2008;152(4):494–501.
74. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.
75. Daniels SR, Pratt CA, Hayman LL. Reduction of risk for cardiovascular disease in children and adolescents. Circulation. 2011;124(15):1673–86.
76. Knowles G, Pallan M, Thomas GN, Ekelund U, Cheng KK, Barrett T, et al. Physical activity and blood pressure in primary school children: a longitudinal study. Hypertension. 2013;61(1):70–5.
77. Guerra PH, Nobre MR, da Silveira JA, Taddei JA. The effect of school-based physical activity interventions on body mass index: a meta-analysis of randomized trials. Clinics (Sao Paulo). 2013;68(9):1263–73.
78. Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: a meta-analysis. CMAJ. 2009;180(7):719–26.
79. Gopinath B, Hardy LL, Kifley A, Baur LA, Mitchell P. Activity Behaviors in Schoolchildren and Subsequent 5-yr Change in Blood Pressure. Med Sci Sports Exerc. 2014;46(4):724–9.
80. Saunders TJ, Tremblay MS, Mathieu ME, Henderson M, O'Loughlin J, Tremblay A, et al. Associations of sedentary behavior, sedentary bouts and breaks in sedentary time with cardiometabolic risk in children with a family history of obesity. PLoS One. 2013;8(11):e79143.
81. Kalarchian MA, Levine MD, Arslanian SA, Ewing LJ, Houck PR, Cheng Y, et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics. 2009;124(4):1060–8.
82. Sbruzzi G, Eibel B, Barbiero SM, Petkowicz RO, Ribeiro RA, Cesa CC, et al. Educational interventions in childhood obesity: A systematic review with meta-analysis of randomized clinical trials. Prev Med. 2013;56(5):254–64.
83. Meyer AA, Kundt G, Lenschow U, Schuff-Werner P, Kienast W. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. J Am Coll Cardiol. 2006;48(9):1865–70.
84. Lee YH, Song YW, Kim HS, Lee SY, Jeong HS, Suh SH, et al. The effects of an exercise program on anthropometric, metabolic, and cardiovascular parameters in obese children. Korean Circ J. 2010;40(4):179–84.
85. Li JS, Barnett TA, Goodman E, Wasserman RC, Kemper AR. Approaches to the prevention and management of childhood obesity: the role of social networks and the use of social media and related electronic technologies: a scientific statement from the American Heart Association. Circulation. 2013;127(2):260–7.
86. Williamson DA, Walden HM, White MA, York-Crowe E, Newton Jr RL, Alfonso A, et al. Two-year internet-based randomized controlled trial for weight loss in African-American girls. Obesity (Silver Spring). 2006;14(7):1231–43.
87. Chaturvedi S, Lipszyc DH, Licht C, Craig JC, Parekh R. Pharmacological interventions for hypertension in children. Cochrane Database Syst Rev. 2014;2:CD008117. This systemic review summarizes the current evidence for the reader on anithypertensive medications for children with hypertension for those who have persistent hypertension despite intervention with lifestyle modification
88. Yoon EY, Cohn L, Rocchini A, Kershaw D, Freed G, Ascione F, et al. Antihypertensive prescribing patterns for adolescents with primary hypertension. Pediatrics. 2012;129(1):e1–8.
89. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386–93.