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Reductions in blood pressure during a community-based overweight and obesity treatment in children and adolescents with prehypertension and hypertension

Journal of Human Hypertension volume 31, pages 640–646 (2017)Cite this article

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Abstract

Due to the pandemic of childhood obesity and thus obesity-related hypertension, improvements in treatment availability are needed. Hence, we investigated whether reductions in blood pressure (BP) would occur in children with overweight and obesity exhibiting prehypertension/hypertension during a community-based overweight and obesity treatment program, and if changes in body mass index (BMI) are associated with changes in BP. The study included 663 children aged 3–18 years with a BMI ⩾85th percentile for sex and age that entered treatment from June 2012 to January 2015. Height, weight and BP were measured upon entry and every 3–6 months. BMI and BP s.d. scores (SDSs) were calculated according to sex and age, or sex, age and height. Prehypertension was defined as a BP SDS ⩾1.28 and <1.65. Hypertension was defined as a BP SDS ⩾1.65. Upon entry, 52% exhibited prehypertension (11.9%) or exhibited hypertension (40.1%). After 12 months (range: 3–29) of treatment, 29.3% of the children with prehypertension/hypertension were normotensive. Children with systolic prehypertension/hypertension upon entry reduced their systolic BP SDSs by 0.31 (95% confidence interval (CI): 0.70–0.83, P<0.0001). Children with diastolic prehypertension/hypertension upon entry reduced their diastolic BP SDSs by 0.78 (95% CI: 0.78–0.86, P<0.0001). BMI SDS changes were positively associated with BP SDS changes (P<0.0001). Nonetheless, some children reduced BP SDSs while increasing their BMI SDSs, and prehypertension/hypertension developed in 23.3% of the normotensive children despite reductions in BMI SDSs (P<0.0001). These results suggest that community-based overweight and obesity treatment can reduce BP, and thus may help improve treatment availability.

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Acknowledgements

We thank Rikke Melskens for her supervision of the community-based treatment. We also thank the staff at The Children’s Obesity Clinic at the Copenhagen University Hospital Holbæk and staffs at the healthcare centres in Hedensted, Holbæk, Horsens, Kalundborg, Kolding, Slagelse, Stevns and Vejle for their work and participation in the study. Thanks to the children and their families for their participation in the study. The study was funded by the Region Zealand, the Region Zealand Health Scientific Research Foundation, The Novo Nordisk Foundation (grant number NNF15OC0016544), the Innovation Fund Denmark (grant numbers 0603-00484B and 0603-00457B), and the Aase and Ejnar Danielsen’s Foundation. The study was a part of the research activities in ‘The Danish Childhood Obesity Biobank’ (ClinicalTrials.gov, ID-no.: NCT00928473), which is conducted in collaboration with the research activities in ‘TARGET’ (The Impact of our Genomes on Individual Treatment Response in Obese Children, www.target.ku.dk) and ‘BIOCHILD’ (www.biochild.ku.dk). The Novo Nordisk Foundation Center for Basic Metabolic Research is an independent research centre at the University of Copenhagen partially funded by an unrestricted donation from the Novo Nordisk Foundation (www.metabol.ku.dk).

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Authors and Affiliations

  1. Department of Pediatrics, The Children’s Obesity Clinic, Copenhagen University Hospital Holbæk, Holbæk, Denmark

    P M Mollerup, U Lausten-Thomsen, C E Fonvig & J-C Holm

  2. Section of Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark

    C E Fonvig, J L Baker & J-C Holm

  3. Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Frederiksberg, Denmark

    J L Baker

  4. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    J-C Holm

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  1. P M Mollerup
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Correspondence to P M Mollerup.

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Mollerup, P., Lausten-Thomsen, U., Fonvig, C. et al. Reductions in blood pressure during a community-based overweight and obesity treatment in children and adolescents with prehypertension and hypertension. J Hum Hypertens 31, 640–646 (2017). https://doi.org/10.1038/jhh.2017.36

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