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Obesity Hypertension: Clinical Aspects

Pediatric Hypertension
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Abstract

Overweight and obesity in children and adolescents are quite common, and they are associated with the development of numerous clinical consequences such as hypertension. This chapter will provide a review of the definitions of hypertension and prehypertension in children and adolescents and then discuss the epidemiology of obesity hypertension. After examining the complex relationship between obesity and hypertension and potential mechanisms contributing to the development of obesity hypertension, clinical approaches to the management of hypertension in the setting of obesity are discussed. The clinical management is multifaceted, as one must consider that treating obesity may in fact lead to improved blood pressure. Yet, treating obesity takes time and motivation, and while awaiting the effects of changes in lifestyle on blood pressure, use of antihypertensive medications may be indicated in some children and adolescents.

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References

  • Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ (2013) Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ 346:f1326

    Article  PubMed  PubMed Central  Google Scholar 

  • Aggoun Y, Bonnet D, Sidi D, Girardet JP, Brucker E, Polak M, Safar ME, Levy BI (2000) Arterial mechanical changes in children with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol 20:2070–2075

    Article  CAS  PubMed  Google Scholar 

  • Alpert BS (2000) Exercise as a therapy to control hypertension in children. Int J Sports Med 21(Suppl 2):S94–S96

    Article  PubMed  Google Scholar 

  • Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin P, Karanja N, for the DASH Collaborative Research Group (1997) A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 336:1117–1124

    Article  CAS  PubMed  Google Scholar 

  • Babinska K, Kovacs L, Janko V, Dallos T, Feber J (2012) Association between obesity and severity of ambulatory hypertension in children and adolescents. J Am Soc Hypertens 6:356–363

    Article  CAS  PubMed  Google Scholar 

  • Bao W, Threefoot SA, Srinivasan SR, Berenson GS (1995) Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 8:657–665

    Article  CAS  PubMed  Google Scholar 

  • Batisky DL (2012) What is the optimal first-line agent in children requiring antihypertensive medication? Curr Hypertens Rep 14:603–607

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bistrian BR (1978) Clinical use of a protein-sparing modified fast. JAMA 240:2299–2302

    Article  CAS  PubMed  Google Scholar 

  • Brownell KD, Kelman JH, Stunkard AJ (1983) Treatment of obese children with and without their mothers: changes in weight and blood pressure. Pediatrics 71:515–523

    CAS  PubMed  Google Scholar 

  • Burt VL et al (1993) Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension 26:60–69

    Article  Google Scholar 

  • Chandramohan G, Kalantar-Zadeh K, Kermah D, Go SC, Vaziri ND, Norris KC (2012) Relationship between obesity and pulse pressure in children: results of the National Health and Nutrition Survey (NHANES) 1988–1994. J Am Soc Hypertens 6:277–283

    Article  PubMed  PubMed Central  Google Scholar 

  • Chen X, Wang Y (2008) Tracking of blood pressure from childhood to adulthood: a systematic review and meta–regression analysis. Circulation 117:3171–3180

    Article  PubMed  PubMed Central  Google Scholar 

  • Chen W, Srinivasan SR, Elkasabany A, Berenson GS (1999) Cardiovascular risk factors clustering features of insulin resistance syndrome (Syndrome X) in a biracial (Black-White) population of children, adolescents, and young adults. The Bogalusa Heart Study. Am J Epidemiol 150:667–674

    Article  CAS  PubMed  Google Scholar 

  • Chrousos GP (1995) The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 332:1351–1362

    Article  CAS  PubMed  Google Scholar 

  • Clarke WR, Woolson RF, Lauer RM (1986) Changes in ponderosity and blood pressure in childhood. The Muscatine Study. Am J Epidemiol 124:195–206

    Article  CAS  PubMed  Google Scholar 

  • Colman E, Golden J, Roberts M, Egan A, Weaver J, Rosebraugh C (2012) The FDA’s assessment of two drugs for chronic weight management. N Engl J Med 367:1577–1579

    Article  CAS  PubMed  Google Scholar 

  • Couch SC, Saelens BE, Levin L, Dart K, Falcigua G, Daniels SR (2008) The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. J Pediatr 152:494–501

    Article  PubMed  Google Scholar 

  • Csabi G, Molnar D, Hartmann G (1996) Urinary sodium excretion: association with hyperinsulinaemia, hypertension and sympathetic nervous system activity in obese and control children. Eur J Pediatr 155:895–897

    Article  CAS  PubMed  Google Scholar 

  • Daniels SR, Hassink SG, Committee on Nutrition (2015) The role of the pediatrician in primary prevention of obesity. Pediatrics 136:e275–e292

    Article  PubMed  Google Scholar 

  • Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K (2007) Recommendations for prevention of childhood obesity. Pediatrics 120(Suppl 4):S229–S253

    Article  PubMed  Google Scholar 

  • de Onis M, Blossner M, Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257–1264

    Article  PubMed  Google Scholar 

  • Department of Health (2002) Health Survey for England: trend data for adults. 1993–2000. Department of Health. Available at: http://www.doh.gov.uk/stats/trends1.htm

  • Drizd T, Dannenberg AL, Engel A (1986) Blood pressure levels in persons 18–74 years of age in 1976–80, and trends in blood pressure from 1960 to 1980 in the United States. Vital Health Stat 11:1–68

    Google Scholar 

  • Elcarte LR, Villa EI, Sada GJ, Gasco EM, Oyarzabai IM, Sola MA, Martino GA, Elacrte LT, Ayensa MI, Castiella LF (1995) The Navarra study. Prevalence of arterial hypertension, hyperlipidemia and obesity in the infant-child population of Navarra. Association of risk factors. An Esp Pediatr 38:428–436

    Google Scholar 

  • Epstein LH, Valoski A, Wing RR, McCurley J (1990) Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA 264:2519–2523

    Article  CAS  PubMed  Google Scholar 

  • Falkner B, Gidding SS, Portman R, Rosner B (2008) Blood pressure variability and classification prehypertension and hypertension in adolescence. Pediatrics 122:238–242

    Article  PubMed  Google Scholar 

  • Figueroa-Colon R, von Almen TK, Franklin FA, Schuftan C, Suskind RM (1993) Comparison of two hypocaloric diets in obese children. Am J Dis Child 147:160–166

    CAS  PubMed  Google Scholar 

  • Freedman DS, Dietz WH, Srinivasan SR, Berenson GS (1999) The relation of overweight to cardiovascular risk factors among children and adolescents. The Bogalusa Heart Study. Pediatrics 103:1175–1182

    Article  CAS  PubMed  Google Scholar 

  • Gallistl S, Sudi KM, Aigner R, Borkenstein M (2001) Changes in serum interleukin-6 concentrations in obese children and adolescents during a weight reduction program. Int J Obes Relat Metab Disord 25:1640–1643

    Article  CAS  PubMed  Google Scholar 

  • Godoy-Matos AF, Guedes EP, Souza LL, Martins MF (2009) Management of obesity in adolescents: state of art. Arq Bras Endocrinol Metabol 53:252–261

    Article  PubMed  Google Scholar 

  • Gomez-Marin O, Prineas RJ, Rastam L (1992) Cuff bladder width and blood pressure measurement in children and adolescents. J Hypertens 10:1235–1241

    Article  CAS  PubMed  Google Scholar 

  • Grontved A, Steene-Johannessen J, Kynde I, Franks PW, Helge JW, Froberg K, Anderssen SA, Andersen LB (2011) Association between plasma leptin and blood pressure in two population-based samples of children and adolescents. J Hypertens 29:1093–1100

    Article  CAS  PubMed  Google Scholar 

  • Guillaume M, Lapidus L, Beckers F, Lambert A, Bjorntorp P (1996) Cardiovascular risk factors in children from the Belgian province of Luxembourg. The Belgian Luxembourg Child Study. Am J Epidemiol 144:867–880

    Article  CAS  PubMed  Google Scholar 

  • Gunther ALB, Liese AD, Bell RA, Dabelea D, Lawrence JM, Rodriguez BL, Standiford DA, Mayer-Davis EJ (2009) Association between the dietary approaches to hypertension diet and hypertension in youth with diabetes mellitus. Hypertension 53:6–12

    Article  PubMed  Google Scholar 

  • Gutin B, Owens S, Slavens G, Riggs S, Treiber F (1997) Effect of physical training on heart-period variability in obese children. J Pediatr 130:938–943

    Article  CAS  PubMed  Google Scholar 

  • Heinemann L, Barth W, Hoffmeister H (1995) Trend of cardiovascular risk factors in the East German population 1968-1992. J Clin Epidemiol 48:787–795

    Article  CAS  PubMed  Google Scholar 

  • Ho M, Garnett SP, Baur L, Burrows T, Stewart L, Neve M, Collins C (2012) Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics 130:e1647–e1671

    Article  PubMed  Google Scholar 

  • Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, Harmon CM, Zeller MH, Chen MK, Xanthakos SA, Horlick M (2016) Buncher CR for the Teen-LABS consortium. N Engl J Med 374:113–123

    Article  CAS  PubMed  Google Scholar 

  • Jarvisalo MJ, Jartti L, Nanto-Salonen K, Irjala K, Ronnemaa T, Hartiala JJ, Celermajer DS, Raitakari OT (2001) Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 104:2943–2947

    Article  CAS  PubMed  Google Scholar 

  • Jarvisalo MJ, Putto-Laurila A, Jartti L, Lehtimaki T, Solakivi T, Ronnemaa T, Raitakari OT (2002) Carotid artery intima-media thickness in children with type 1 diabetes. Diabetes 51:493–498

    Article  CAS  PubMed  Google Scholar 

  • Juhola J, Oikonen M, Magnussen CG et al (2012) Childhood physical, environmental, and genetic predictors of adult hypertension. The Cardiovascular Risk in Young Finns Study. Circulation 126:402–409

    Article  PubMed  Google Scholar 

  • Jung RT, Shetty PS, Barrand M, Callingham BA, James WP (1979) Role of catecholamines in hypotensive response to dieting. Br Med J 1:12–13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jung X, Srinivasan SR, Urbina E, Berenson GS (1995) Hyperdynamic circulation and cardiovascular risk in children and adolescents. The Bogalusa Heart Study. Circulation 91:1101–1106

    Article  Google Scholar 

  • Kanai H, Matsuzawa Y, Tokunaga K, Keno Y, Kobatake T, Fujioka S, Nakajima T, Tarui S (1990) Hypertension in obese children: fasting serum insulin levels are closely correlated with blood pressure. Int J Obes 14:1046–1056

    Google Scholar 

  • Kapur G, Ahmed M, Pan C, Mitsnefes M, Chiang M, Mattoo T (2010) Secondary hypertension in overweight and Stage 1 hypertensive children: a Midwest Pediatric Nephrology Consortium report. J Clin Hypertens 12:34–39

    Article  Google Scholar 

  • Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G (2010) Mechanisms of obesity-induced hypertension. Hypertens Res 33:386–393

    Article  PubMed  Google Scholar 

  • Krebs NF, Jacobson MS, American Academy of Pediatrics Committee on Nutrition (2003) Prevention of pediatric overweight and obesity. Pediatrics 112:424–430

    Article  PubMed  Google Scholar 

  • LaBresh KA, Lazorick S, Ariza AJ, Furberg RD, Whetstone L, Hobbs C, de Jesus J, Bender RH, Salinas IG (2014) Implementation of the NHLBI integrated guidelines for Cardiovascular Health and Risk Reduction in children and adolescents: rationale and study design for Young Hearts, Strong Starts, a cluster-randomized trial targeting body mass index, blood pressure, and tobacco. Contemp Clin Trials 37:98–105

    Article  PubMed  Google Scholar 

  • Lo JC, Sinaiko A, Chandra M, Daley MF, Greenspan LC, Parker ED, Kharbanda EO, Margolis KL, Adams K, Prineas R, Magid D, O’Connor PJ (2013) Prehypertension and hypertension in community-based pediatric practice. Pediatrics 131:e425–e424

    Article  Google Scholar 

  • Luepker RV et al (1988) Cardiovascular risk factor change—1974–74 to 1980–82: the Minnesota Heart Survey. J Clin Epidemiol 41:825–833

    Article  CAS  PubMed  Google Scholar 

  • Lughetti L, Bedogni G, Ferrari M, Pagliato E, Manzieri AM, De Simone M, Battistini N, Bernasconi S (2000) Is fasting insulin associated with blood pressure in obese children? Ann Hum Biol 27:499–506

    Article  Google Scholar 

  • Macedo ME, Trigueiros D, de Freitas F (1997) Prevalence of high blood pressurein children and adolescents. Influence of obesity. Rev Port Cardiol 16:27–28

    CAS  PubMed  Google Scholar 

  • Macumber IR, Weiss NS, Halbach SM, Hanevold CD, Flynn JT (2016) The association of pediatric obesity with nocturnal non-dipping on 24-hour ambulatory blood pressure monitoring. Am J Hypertens 29:647–652

    Article  PubMed  Google Scholar 

  • Martini G, Riva P, Rabbia F, Molini V, Ferrero GB, Cerutti F, Carra R, Veglio F (2001) Heart rate variability in childhood obesity. Clin Auton Res 11:87–91

    Article  CAS  PubMed  Google Scholar 

  • May AL, Kuklina EV, Yoon PW (2012) Prevalence of cardiovascular disease risk factors among US adolescents, 1999–2008. Pediatrics 129:1035–1041

    Article  PubMed  Google Scholar 

  • Mohamed-Ali V, Bulmer K, Clarke D, Goodrick S, Coppack SW, Pinkney JH (2000) Beta-adrenergic regulation of proinflammatory cytokines in humans. Int J Obes Relat Metab Disord 24:S154–S155

    Article  CAS  PubMed  Google Scholar 

  • Moore LL, Singer MR, Bradlee ML, Djousse’ L, Proctor MH, Cupples LA, Ellison RC (2005) Epidemiology 16(1):4–11

    Article  PubMed  Google Scholar 

  • Mu JJ, Liu ZQ, Liu WM, Liang YM, Yang DY, Zhu DJ, Wang ZX (2005) Reduction of blood pressure with calcium and potassium supplementation in children with salt sensitivity: a 2-year double-blinded placebo-controlled trial. J Hum Hypertens 19:479–483

    Article  CAS  PubMed  Google Scholar 

  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2005) The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. National Institutes of Health, Bethesda. NIH publication 05: 5267

    Google Scholar 

  • National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health (1993) Very low-calorie diets. JAMA 270:967–974

    Article  Google Scholar 

  • Nguyen T, Lau DCW (2012) The obesity epidemic and its impact on hypertension. Can J Cardiol 28:326–333

    Article  PubMed  Google Scholar 

  • Parikh A, Sochett EB, McCrindle BW, Dipchand A, Daneman A, Daneman D (2000) Carotid artery distensibility and cardiac function in adolescents with type 1 diabetes. J Pediatr 137:465–469

    Article  CAS  PubMed  Google Scholar 

  • Peppa-Patrikiou M, Scordili M, Antoniou A, Giannaki M, Dracopoulou M, Dacou-Voutetakis C (1998) Carotid atherosclerosis in adolescents and young adults with IDDM. Relation to urinary endothelin, albumin, free cortisol, and other factors. Diabetes Care 21:1004–1007

    Article  CAS  PubMed  Google Scholar 

  • Pozzan R, Brandao AA, de Silva SL, Brandao AP (1997) Hyperglycemia, hyperinsulinemia, overweight, and high blood pressure in young adults. The Rio de Janeiro Study. Hypertension 30:650–653

    Article  CAS  PubMed  Google Scholar 

  • Prineas RJ (1991) Measurements of blood pressure in the obese. Ann Epidemiol 1:321–336

    Article  CAS  PubMed  Google Scholar 

  • Prineas RJ, Ostchega Y, Carroll M, Dillon C, McDowell M (2007) Blood Press Monit 12:75–80

    Article  PubMed  Google Scholar 

  • Redwine K, Acosta A, Poffenbarger T, Portman R, Samuels J (2012) Development of hypertension in adolescents with prehypertension. J Pediatr 160:98–103

    Article  PubMed  Google Scholar 

  • Ribeiro MM, Silva AG, Santos NS, Guazzelle I, Matos LN, Trombetta IC, Halpern A, Negrão CE, Villares SM (2005) Diet and exercise training restore blood pressure and vasodilatory responses during physiologiocal maneuvers in obese children. Circulation 111:1915–1923

    Article  PubMed  Google Scholar 

  • Riva P, Martini G, Rabbia F, Milan A, Paglieri C, Chiandussi L, Veglio F (2001) Obesity and autonomic function in adolescence. Clin Exp Hypertens 23:57–67

    Article  CAS  PubMed  Google Scholar 

  • Roberts J, Maurer K (1977) Blood pressure of youths 12–17 years: United States. Vital Health Stat 1:iii–i62

    Google Scholar 

  • Rocchini AP (2004) Childhood obesity and blood pressure regulation. In: Portman RJ, Sorof JM, Ingelfinger JR (eds) Pediatric hypertension, 1st edn. Humana Press, Totowa, pp 307–334

    Chapter  Google Scholar 

  • Rocchini AP (2010) Childhood obesity and blood pressure regulation. In: Flynn JT, Ingelfinger JR, Portman RJ (eds) Pediatric hypertension, 2nd edn. Springer, pp 301–327

    Google Scholar 

  • Rocchini AP, Katch V, Schork A, Kelch RP (1987) Insulin and blood pressure during weight loss in obese adolescents. Hypertension 10:267–273

    Article  CAS  PubMed  Google Scholar 

  • Rocchini AP, Katch V, Anderson J, Hinderliter J, Becque D, Martin M, Marks C (1988) Blood pressure in obese adolescents: effect of weight loss. Pediatrics 82:16–23

    CAS  PubMed  Google Scholar 

  • Rocchini AP, Moorehead C, Katch V, Key J, Finta KM (1992) Forearm resistance vessel abnormalities and insulin resistance in obese adolescents. Hypertension 19:615–620

    Article  CAS  PubMed  Google Scholar 

  • Rosner B, Prineas R, Daniels SR, Loggie J (2000) Blood pressure differences between blacks and whites in relation to body size among US children and adolescents. Am J Epidemiol 151:1007–1019

    Article  CAS  PubMed  Google Scholar 

  • Rosner B, Cook N, Portman R, Daniels S, Falkner B (2008) Determination of blood pressure percentiles in normal-weight children: some methodological issues. Am J Epidemiol 167:653–666

    Article  CAS  PubMed  Google Scholar 

  • Roulet C, Bovet P, Brauchli T, Simeoni U, Xi B, Santschi V, Paradis G, Chiolero A (2016) Secular trends in blood pressure in children: a systematic review. J Clin Hypertens 1–10

    Google Scholar 

  • Rowland M, Roberts J (1982) Blood pressure levels and hypertension in persons ages 6–74 years: United States, 1976–90. Adv Data 84:1–11

    Google Scholar 

  • Saito I, Nishino M, Kawabe H, Wainai H, Hasegawa C, Saruta T, Nagano S, Sekihara T (1992) Leisure time physical activity and insulin resistance in young obese children. Am J Hypertens 5:915–918

    Article  CAS  PubMed  Google Scholar 

  • Sharma AM, Pischon T, Engeli S, Scholze J (2001) Choice of drug treatment for obesity-related hypertension: where is the evidence? J Hypertens 19:667–674

    Article  CAS  PubMed  Google Scholar 

  • Shatat IF, Freeman KD, Vuquin PM, Dimartino-Nardi JR, Flynn JT (2009) Relationship between adiponectin and ambulatory blood pressure in obese adolescents. Pediatr Res 65:691–695

    Article  CAS  PubMed  Google Scholar 

  • Shaw A, McMunn A, Field J (2000) The Scottish Health Survey 1998, Edinburgh. Joint Health Surveys Unit of Social and Community Planning Research and University College London. Available at: http://www.show.scot.nhs.uk/scottishhealthsurvey/sh8-00.html

  • Sinaiko AR (1996) Hypertension in children. N Engl J Med 335:1968–1973

    Article  CAS  PubMed  Google Scholar 

  • Singhal V, Schwenk WF, Kumar S (2007) Evaluation and management of childhood and adolescent obesity. Mayo Clin Proc 82:1258–1264

    Article  PubMed  Google Scholar 

  • Sjol A, Thomsen KK, Schroll M (1998) Secular trends in blood pressure levels in Denmark 1964–1991. Int J Epidemiol 27:614–622

    Article  CAS  PubMed  Google Scholar 

  • Sorof JM, Poffenberger T, Franco K, Bernard L, Portman RJ (2002) Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children. J Pediatr 140:660–666

    Article  PubMed  Google Scholar 

  • Sorof JM, Lai D, Turner J, Poffenbarger, Portman RJ (2004) Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 113:475–482

    Article  PubMed  Google Scholar 

  • Tershakovec AM, Watson MH, Wenner WJJ, Marx AL (1999) Insurance reimbursement for the treatment of obesity in children. J Pediatr 134:573–578

    Article  CAS  PubMed  Google Scholar 

  • Tonstad S, Joakimsen O, Stensland-Bugge E, Leren TP, Ose L, Russell D, Bonaa KH (1996) Risk factors related to carotid intima-media thickness and plaque in children with familial hypercholesterolemia and control subjects. Arterioscler Thromb Vasc Biol 16:984–991

    Article  CAS  PubMed  Google Scholar 

  • Torrance B, McGuire KA, Lewanczuk R, McGavock J (2007) Vasc Health Risk Manag 3(1):139–149

    PubMed  PubMed Central  Google Scholar 

  • Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, Girardet JP, Bonnet D (2001) Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 358:1400–1404

    Article  CAS  PubMed  Google Scholar 

  • Verma M, Chhatwal J, George SM (1994) Obesity and hypertension in children. Indian J Pediatr 31:1065–1069

    CAS  Google Scholar 

  • Virkola K, Pesonen E, Akerblom HK, Siimes MA (1997) Cholesterol and carotid artery wall in children and adolescents with familial hypercholesterolaemia: a controlled study by ultrasound. Acta Paediatr 86:1203–1207

    Article  CAS  PubMed  Google Scholar 

  • Voors AW, Radhakrishnamurthy B, Srinivasan SR, Webber LS, Berenson GS (1981) Plasma glucose level related to blood pressure in 272 children, ages 7–15 years, sampled from a total biracial population. Am J Epidemiol 113:347–356

    Article  CAS  PubMed  Google Scholar 

  • Voors AW, Webber LS, Berenson GS (1982) Resting heart rate and pressure-rate product of children in a total biracial community. The Bogalusa Heart Study. Am J Epidemiol 116:276–286

    Article  CAS  PubMed  Google Scholar 

  • Wabitsch M, Hauner H, Heinze E, Muche R, Bockmann A, Parthon W, Mayer H, Teller W (1994) Body-fat distribution and changes in the atherogenic risk-factor profile in obese adolescent girls during weight reduction. Am J Clin Nutr 60:54–60

    CAS  PubMed  Google Scholar 

  • Welch WP, Yang W, Taylor-Zapata P, Flynn JT (2012) Antihypertensive drug use by children: are the drugs labeled and indicated? J Clin Hypertens 14:388–395

    Article  Google Scholar 

  • Whincup PH, Cook DG, Shaper AG (1989) Blood pressure measurement in children: the importance of cuff bladder size. J Hypertens 7:845–850

    Article  CAS  PubMed  Google Scholar 

  • Yang Q, Zhang Z, Kuklina EV, Fang J, Ayala C, Hong Y, Loustalot F, Dai S, Gunn JP, Tian N, Cogswell ME, Merritt R (2012) Sodium intake and blood pressure among US children and adolescents. Pediatrics 130:611–619

    Article  PubMed  Google Scholar 

  • Young-Hyman D, Schlundt DG, Herman L, De Luca F, Counts D (2001) Evaluation of the insulin resistance syndrome in 5- to 10-year-old overweight/obese African-American children. Diabetes Care 24:1359–1364

    Article  CAS  PubMed  Google Scholar 

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Batisky, D.L. (2017). Obesity Hypertension: Clinical Aspects. In: Flynn, J., Ingelfinger, J., Redwine, K. (eds) Pediatric Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-31420-4_17-1

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  1. Latest

    Obesity Hypertension: Clinical Aspects
    Published:
    19 May 2022

    DOI: https://doi.org/10.1007/978-3-319-31420-4_17-2

  2. Original

    Obesity Hypertension: Clinical Aspects
    Published:
    20 February 2017

    DOI: https://doi.org/10.1007/978-3-319-31420-4_17-1