The prevalence of elevated blood pressure among obese adolescents in a pediatric resident continuity clinic.

OBJECTIVE

The purpose of this study is to examine the association of obesity and elevated blood pressure among adolescent patients in a pediatric resident continuity clinic.

METHODS

Blood pressure and anthropometric data from adolescent patients (ages 12-18 years) in a resident continuity clinic were analyzed. Age-and gender-specific BMI percentiles, and age-, gender-, and height-specific BP percentiles were determined. Based on BMI percentile, patients were categorized as underweight (BMI < 5th percentile), healthy (5th-84th percentile), overweight (85th-94th percentile), or obese (> or = 95th percentile). BP was classified as normal (< 90th percentile), pre-hypertensive (90th-94th percentile or > 120/80 mm Hg), or hypertensive (> or = 95th percentile).

RESULTS

Data from 317 consecutive visits were available for analysis. Eighteen percent were classified as overweight, and 29.1% were obese. There were no gender differences in BMI category. Almost 15% of BPs were classified as hypertensive, with another 23% pre-hypertensive. Males were more likely to be pre-hypertensive or hypertensive than females. Among obese patients, more than half had elevated BP: 31.5% were pre-hypertensive and 26.1% were hypertensive.

CONCLUSIONS

The prevalence of obesity in this cohort was higher than estimates based on national data. Further, the prevalence of elevated blood pressure increased with increasing BMI. This study underscores the importance of recognizing and addressing obesity and elevated blood pressure in an at-risk population. The potential public health impact of the early onset of obesity and elevated blood pressure, particularly with regard to cardiovascular disease burden, highlights the need to prepare residents to identify and manage these conditions.