Effect of changes in BMI and waist circumference on ambulatory blood pressure in obese children and adolescents

J Hypertens. 2014 Jul;32(7):1470-7; discussion 1477. doi: 10.1097/HJH.0000000000000188.


Background: Weight reduction has been accompanied with a reduction in clinic blood pressure (BP) in children and adolescents; however, the effect on ambulatory BP (ABP) is uncertain. The objective was to investigate the impact of weight changes on ABP in obese children and adolescents.

Methods: Sixty-one severely obese patients aged 10-18 years underwent lifestyle intervention at the Children's Obesity Clinic. Patients were examined with ABP monitoring at baseline and after 1 year of treatment (follow-up). To account for growth, BP and BMI were standardized into z scores, whereas waist circumference was indexed by height [waist/height ratio (WHR)].

Results: Patients experienced a reduction at follow-up in the degree of obesity [ΔBMI z score: -0.21, 95% confidence interval (CI) -0.32 to -0.10, P = 0.0003; and ΔWHR: -0.02, 95% CI -0.03 to -0.004, P = 0.009]. Δ24-h, Δdaytime and Δnight-time SBP and DBP in mmHg and changes in equivalent z scores were related to ΔBMI z scores and ΔWHR. These relationships were reproduced in multiple regression analyses adjusted for relevant confounders, for example, a reduction in one BMI z score corresponds to a reduction in 24-h SBP by 6.5 mmHg (P < 0.05). No relationship was found between changes in these anthropometric obesity measures and changes in clinic BP.

Conclusion: Changes in obesity measures were closely related to changes in ABP, but not to changes in clinic BP, in severe obese children and adolescents after 1 year of lifestyle intervention. The findings emphasize the use of 24-h ABP measurements in children and adolescents.

Trial registration: ClinicalTrials.gov NCT00928473.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Pressure / physiology*
  • Blood Pressure Monitoring, Ambulatory
  • Body Mass Index
  • Child
  • Circadian Rhythm
  • Female
  • Humans
  • Male
  • Obesity / pathology*
  • Obesity / physiopathology*
  • Obesity / therapy
  • Waist Circumference
  • Weight Loss / physiology*

Associated data

  • ClinicalTrials.gov/NCT00928473