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Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

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1. Among obese adolescents, hypertension was most prevalent in white individuals and least prevalent among African American children.

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2. Hispanic and African American adolescents had the highest rates of hypertension regardless of body mass index (BMI).

Study Rundown:

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Currently one third of the pediatric population in the United States is overweight or obese. The highest obesity burden is seen among adolescents from minority groups, and as rates of obesity continue to rise, there has been an epidemiologic shift in the prevalence of pediatric hypertension. This study aimed to characterize the relationship between race/ethnicity, BMI, and blood pressure (BP) among adolescents using data collected from screening visits at 27 schools in Houston, Texas. Results showed that African American and Hispanic adolescents had both the highest rates of obesity and the highest prevalence of hypertension individually. However, this study also found that obesity had the lowest impact on BP among African American adolescents compared with children of Hispanic and white race. Although this study described variation in hypertension rates in the context of race and BMI, it failed to identify specific causes for these differences. Further studies are needed to better understand how BMI and race/ethnicity affect individual risk of hypertension in the pediatric population.

In-depth [cross-sectional study]:

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Researchers collected information on race, sex, age, BMI, and blood pressure from 21 062 adolescents aged 10-19 years (52% female, 35% Hispanic, 33% white, 25% African American) during health screening visits at 27 secondary schools in Houston, Texas between 2000 and 2015. Children found to have abnormal BP (≥120/80 mmHg or >90th percentile for age, sex and height) at the first visit were asked to be re-screened at 2 additional visits to confirm the presence of sustained hypertension. BP measurements for all participants were averaged, and hypertension was defined as mean systolic or diastolic BP ≥ the 95th percentile for age, sex, and height. Results found the overall prevalence of hypertension among study participants was 2.7%, with the highest rates in Hispanic (3.1%) and African American (2.7%) adolescents. The study also found significantly higher rates of hypertension among obese individuals (6.6%) than their peers with normal BMIs (1.6%, p < .001). African American individuals had the highest prevalence of obesity followed by Hispanic children (3.1% and 2.7% respectively). When BP was analyzed in the context of BMI and race, obese Hispanic and white students were found to have the highest prevalence of hypertension (7.7% and 7.4%, respectively). Despite having the highest rates of hypertension among normal and overweight students, obese African American adolescents had lower rates of hypertension (4.5%) compared with their Hispanic and white counterparts. Asian students had the lowest rates of obesity and hypertension regardless of BMI. Hypertension rates were greater in males versus females (3.3% vs. 2.1%) overall. Of note, rates increased with age among males while they decreased with age among females.

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