Overweight, high blood pressure and arterial stiffness in early childhood

Background
Obesity’s adverse impact on blood pressure (BP) and its association with impaired arterial function have been increasingly explored in the young. However, research has paid little attention to early childhood. The objective of this study was to investigate whether elevated BP and arterial stiffness occur more often in overweight or obese (OWOB) with focus on preschool children.
Methods
The data were baseline measurements of 150 children aged 2 to 6 years (4.79 ± 0.83, 52.7 % females) participating in the Fitness for Kids cluster randomized controlled trial. Heart rate, brachial and aortic BP, pulse pressure (PP), mean arterial BP (MAP), augmentation pressure (AugP) and index (Aix), as well as pulse wave velocity (PWV) were measured non-invasively using an oscillometric device (Mobil-O-Graph, I.E.M. Stolberg, Germany). We applied multilevel linear and logistic models with daycare centers as a random intercept, adjusting for age, height, sex (BP variables) and heart rate (PWV, AugP, Aix) to estimate the effect of OWOB (BMI ≥P90 according to German reference data) on BP and arterial stiffness.
Results
Prevalence of OWOB was 10.7 % overall, and 22.2 % in those who exhibited an elevated SBP (≥P95 according to the German KiGGS Study reference values) compared to children with normal SBP (7.5 %). Children who were OWOB demonstrated 4.5, 4.8, 9.1 and 3.8 % higher brachial SBP, aortic SBP, aortic PP and PWV (all P<0.05), respectively, but no significant differences regarding Aix or AugP compared to normalweight children could be detected. The odds of having an elevated SBP were significantly higher in OWOB opposed to their normalweight peers (OR = 3.43, 95 % CI 1.18–10.00, P = 0.024), and PWV was significantly higher in hypertensive children even after adjusting for BMI and MAP (4.47 ± 0.15 vs. 4.26 ± 0.17; 0.21 m/s, 95 % CI 0.14–0.28, P<0.001).
Conclusions
The results suggest that overweight is simultaneously associated with adverse BP levels and stiffer arteries, even in preschool children. Early treatment and prevention of overweight must obtain a priority because it may prevent irreversible damage to the cardiovascular system. The small sample size must be taken into account. More research is required to examine the differential interaction between overweight, high blood pressure and arterial stiffness.