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, 53 (1), 45-55

Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study

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Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study

Somi Heo et al. J Prev Med Public Health.

Abstract

Objectives: This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.

Methods: This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.

Results: Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.

Conclusions: Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Keywords: Adolescents; Hypertension; Obesity; Republic of Korea; United States.

Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflicts of interest associated with the material presented in this paper.

Figures

Figure. 1.
Figure. 1.
Flowchart of the study design. KNHANES, Korean National Health and Nutrition Examination Survey; NHANES, National Health and Nutrition Examination Survey.
Figure. 2.
Figure. 2.
Trends in (A) systolic blood pressure (SBP), (B) diastolic blood pressure (DBP), and the prevalence of (C) elevated blood pressure (EBP), and (D) hypertension (HTN) among adolescents aged 10-17 years in Korea and the United States from 2005-2008 to 2013-2016.
Figure. 3.
Figure. 3.
Trends in (A) body mass index (BMI) and the prevalence of (B) overweight, and (C) obesity among adolescents aged 10- 17 years in Korea and the United States from 2005-2008 to 2013-2016.
Figure. 4.
Figure. 4.
Prevalence of (A) elevated blood pressure (EBP) and (B) hypertension (HTN) by obesity level among adolescents aged 10-17 years in Korea and the United States from 2005-2008 to 2013-2016.

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