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Updated Monday, April 1, 2024-01:00

  • Health One in eight people in the world is obese

  • Office Everything you need to know to take your blood pressure correctly

Children and adolescents who are overweight or obese are more likely to become adults with hypertension between the ages of 50 and 64. Once again, research points out the impact of healthy habits in childhood and how they help avoid 'greater evils' when they grow up.

The results of a Swedish population study from the University of Gothenburg have shown that blood pressure develops in childhood. They carried out an analysis by sex in which they observed how the body mass index (BMI) varies in adult men: they saw how it increased linearly from childhood (at age eight) in those who had a higher BMI, with an increase of BMI during puberty. In women, midlife blood pressure increased in linear association with greater change in pubertal BMI, but not with childhood BMI.

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Obesity: "BMI is dead. We must give way to the study of body composition"

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Hypertension, called persistent high blood pressure, has become a major public health challenge in the world due to its high prevalence and the associated risk of cardiovascular disease. The WHO estimates that 1.28 billion adults between 30 and 79 years old live with hypertension worldwide.

High blood pressure is one of the triggers of heart attacks, strokes and chronic kidney diseases, and has become one of the most preventable and treatable causes of premature death worldwide. Modifiable risk factors include unhealthy diets, physical inactivity, and overweight or obesity.

Obesity data in children is at alarming levels. In 2022, more than 390 million children and adolescents aged five to 19 were overweight, of which 160 million were obese, according to WHO data.

Both are two ingredients that will have fatal results in the long term. "Our results suggest that preventing overweight and obesity from childhood is important when trying to achieve healthy blood pressure in adulthood," says lead author Lina Lilja. This work will be presented at this year's European Congress on Obesity (ECO) next May.

It is known that a high BMI in adults is strongly associated with increased blood pressure and hypertension. However, the relative contribution of high BMI during childhood and puberty to blood pressure in midlife is unknown.

Lilja explains that "children and adolescents living with overweight or obesity could benefit from specific initiatives and lifestyle modifications to reduce the significant disease burden associated with high blood pressure in old age due to diseases such as heart attacks, accidents, strokes and kidney damage.

What data demonstrate the Swedes' hypotheses?

To carry out the work, the researchers analyzed data from 1,683 people (858 men and 825 women) born between 1948 and 1968 who participated in two population cohorts: the

Gothenburg BMI Epidemiology Study

(BEST) cohort and the

Swedish BioImage Study. CardioPulmonary

(SCAPIS): to examine the association between BMI during development and systolic and diastolic blood pressure in midlife (50-64 years).

The researchers measured the BMI of BEST Gothenburg cohort participants using school health care records (at age 7 to 8 years) and for young adult age (age 18 to 20 years), obtained from data from school medical care or medical examinations upon enrollment in the army, which was mandatory for young men until 2010.

Information on blood pressure in adults, ages 50 to 64, was obtained from participants in the SCAPIS study. These were not taking medications for high blood pressure at the time of blood pressure measurement. It should be remembered that hypertension or high blood pressure is defined as a systolic blood pressure (SBP) of 140 mmHg or more or a diastolic blood pressure (DBP) of 90 mmHg or more.

In analyzes that included both childhood BMI and change in BMI during puberty in the same model, the results showed that for men, an increase of one unit of BMI relative to the average BMI in childhood (BMI 15.6 kg/ m2) was associated with a 1.30 mmHg increase in systolic blood pressure (popularly known as the 'high') and a 0.75 mmHg increase in diastolic blood pressure (the 'low').

Similarly, a one unit increase in BMI relative to mean BMI at puberty (equivalent to a mean pubertal BMI change of 5.4 kg/m2) in men was associated with a 1.03 mmHg increase in systolic blood pressure and a 0.53 mmHg increase in diastolic blood pressure.

For women, a one-unit increase in BMI during puberty was associated with a 0.96 mmHg increase in systolic blood pressure and a 0.77 mmHg increase in diastolic blood pressure in adulthood. regardless of childhood BMI. In contrast, childhood BMI was not related to systolic or diastolic blood pressure in adulthood, regardless of change in pubertal BMI.

"Although the differences in blood pressure are not very large, if blood pressure is raised slightly over many years, it can damage blood vessels and lead to cardiovascular and kidney disease," explains co-author Jenny Kindblom of Sahlgrenska University Hospital in Sweden. it's a statement.

"Our findings indicate that high blood pressure can originate in the early stages of life," says Kindblom, going on to detail how this entire biological process happens. "Excess fat mass induces chronic low-grade inflammation and endothelial dysfunction [impaired functioning of the lining of blood vessels] already in childhood. Large amounts of visceral abdominal fat increase the risk of developing hypertension in adults."

Kindblom recalls that they had already shown that a large change in pubertal BMI in men is associated with visceral obesity (fat around internal organs) in young adulthood. "Therefore, the increase in visceral fat mass could, in individuals with a high increase in BMI during puberty, be a possible mechanism that contributes to higher blood pressure," emphasizes the expert from the Sahlgrenska center.

For this reason, he insists on the importance of his analysis, "given the growing wave of obesity among children and adolescents. It is vital that we divert the focus from high blood pressure in adults to include people in younger age groups," Kindblom emphasizes.

The authors note that the results come from observational findings, so more studies are needed to understand whether there are specific ages in childhood and/or adolescence at which BMI is particularly important for blood pressure in adulthood. They also point out limitations, such as that in this type of population study a definitive cause-and-effect link between BMI and high blood pressure cannot be determined; blood pressure was measured at a single time point; The analyzes do not consider the influence of other known risk factors, such as diet and physical activity, which could have influenced the results; and because most participants were white, they may not generalize to people from other racial or ethnic groups.