Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Adiposity indicators and blood pressure in children: nothing beyond body mass index?

Journal of Human Hypertension volume 29, pages 211–212 (2015)Cite this article

Subjects

Obesity is a major risk factor for elevated blood pressure in children.1, 2, 3, 4 For instance, in a school-based study of 5207 children aged 10–12 years, the prevalence of hypertension, which is sustained elevated blood pressure over several visits, was 1.5%, 3.9% and 17.5% in normal weight, overweight and obese children, respectively.4 High body mass index (BMI) is commonly used to define overweight and obesity. However, because BMI is merely a proxy for adiposity, there is a longstanding debate about its performance to predict elevated blood pressure (or any other health conditions associated with adiposity) and whether other adiposity indicators, such as waist circumference, waist-to-hip ratio or hip circumference, should not be preferred.5,6

The study by Dong et al.7 in the current issue of the Journal of Human Hypertension offers a high quality and enlightening contribution to this debate.7 Indeed, the authors assessed the association between different adiposity indicators and elevated blood pressure in a huge population-based study of 99 366 participants aged 7–17 years from China. The adiposity indicators evaluated were weight, BMI, waist circumference, waist-to-height ratio, hip circumference, body adiposity index (a construct based on hip circumference and height), waist-to-hip ratio and skinfold thickness, all converted into z-scores.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Díaz ME . Hypertension and obesity. J Hum Hypertens 2002; 16 (Suppl 1): S18–S22.

    Article  Google Scholar 

  2. Chiolero A, Madeleine G, Gabriel A, Burnier M, Paccaud F, Bovet P . Prevalence of elevated blood pressure and association with overweight in children of a rapidly developing country. J Hum Hypertens 2007; 21: 120–127.

    Article  CAS  Google Scholar 

  3. McCrindle BW . Assessment and management of hypertension in children and adolescents. Nat Rev Cardiol 2010; 7: 155–163.

    Article  Google Scholar 

  4. Chiolero A, Cachat F, Burnier M, Paccaud F, Bovet P . Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. J Hypertens 2007; 25: 2209–2217.

    Article  CAS  Google Scholar 

  5. Reilly JJ, Kelly J, Wilson DC . Accuracy of simple clinical and epidemiological definitions of childhood obesity: systematic review and evidence appraisal. Obes Rev 2010; 11: 645–655.

    Article  CAS  Google Scholar 

  6. Chiolero A, Paradis G, Maximova K, Burnier M, Bovet P . No use for waist-for-height ratio in addition to body mass index to identify children with elevated blood pressure. Blood Press 2013; 22: 17–20.

    Article  Google Scholar 

  7. Dong B, Wang Z, Wang H-J, Ma J . Associations between adiposity indicators and elevated blood pressure among Chinese children and adolescents. J Hum Hypertens (e-pub ahead of print 23 October 2014; doi:10.1038/jhh.2014.95).

  8. Savva SC, Tornaritis M, Savva ME, Kourides Y, Panagi A, Silikiotou N et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes 2000; 24: 1453–1458.

    Article  CAS  Google Scholar 

  9. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tatò L . Waist circumference and cardiovascular risk factors in prepubertal children. Obes Res 2001; 9: 179–187.

    Article  CAS  Google Scholar 

  10. Genovesi S, Antolini L, Giussani M, Pieruzzi F, Galbiati S, Valsecchi MG et al. Usefulness of waist circumference for the identification of childhood hypertension. J Hypertens 2008; 26: 1563–1570.

    Article  CAS  Google Scholar 

  11. Bouchard C . BMI, fat mass, abdominal adiposity and visceral fat: where is the 'beef'? Int J Obes 2007; 31: 1552–1553.

    Article  CAS  Google Scholar 

  12. Katzmarzyk PT, Bouchard C . Where is the beef? Waist circumference is more highly correlated with BMI and total body fat than with abdominal visceral fat in children. Int J Obes 2014; 38: 753–754.

    Article  CAS  Google Scholar 

  13. Ulijaszek SJ, Kerr DA . Anthropometric measurement error and the assessment of nutritional status. Br J Nutr 1999; 82: 165–177.

    Article  CAS  Google Scholar 

  14. Chiolero A . Re: "Comparisons of the strength of associations with future type 2 diabetes risk among anthropometric obesity indicators, including waist-to-height ratio: a meta-analysis". Am J Epidemiol 2013; 177: 862.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland

    A Chiolero

Authors
  1. A Chiolero
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Chiolero.

Ethics declarations

Competing interests

The author declares no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chiolero, A. Adiposity indicators and blood pressure in children: nothing beyond body mass index?. J Hum Hypertens 29, 211–212 (2015). https://doi.org/10.1038/jhh.2014.96

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2014.96

Search

Advanced search

Quick links