Effect of body mass index trajectory on hypertension among children and adolescents aged 5–18 years: a retrospective cohort study

Abstract

Background

Hypertension has become increasingly prevalent in Chinese children and adolescents in recent decades, which affects growth and development of children, leads to cognitive decline and multiple target organ damage. Here, we assessed the impact of different body mass index (BMI) trajectories on the occurrence of hypertension in children and adolescents using a cohort study in Northeast China.

Materials and methods

Children and adolescents aged 5–18 years was extracted for physical examination in Fuxin City, Liaoning Province, China during the 2009–2015 period. A latent category growth mixed model (LCGMM) was used to classify BMI changes and analyze the effect of different BMI trajectories on the risk of occurrence of hypertension in these participants within 5 years.

Results

All participates were divided into five BMI trajectories by LCGMM method: slow increasing group (n = 2616, 30.8%), overweight and obesity (OW/OB) group (n = 1141, 13.4%), normal decreasing group (n = 232, 2.7%), stable normal group (n = 4383, 51.6%), and fast-increasing group (n = 120, 1.4%). Compared with the stable normal group, the slow increasing group [adjusted odds ratio (AOR): 1.610, 95% confidence interval (CI): 1.304–1.989], the OW/OB group (AOR: 3.172, 95% CI: 2.500–4.023) and the fast-increasing group (AOR: 2.708, 95% CI: 1.445–5.074) all increased the risk of developing hypertension in children and adolescents.

Conclusion

The potential of developing hypertension varies among groups of children aged 5–18 with different BMI trajectories. Children and adolescents in the normal BMI range (the slow growth group) still need to be aware of the change in BMI trajectory to stop or slow down the progression of BP abnormalities.

KEY MESSAGES

1. Five body mass index trajectories from ages 5–18 years were determined using the LCGMM method, which labeled as the slow increasing group, overweight and obesity (OW/OB) group, normal decreasing group, stable normal group, and fast-increasing group.

2. Different BMI trajectories in children and adolescents aged 5–18 years are differentially associated with the development of hypertension.

3. Increased BMI levels in children and adolescents increase the risk of hypertension. Moreover, even within the normal BMI range, a modest growth might raise the risk of high-normal BP.

Keywords:

• Children and adolescents
• blood pressure
• hypertension
• body mass index trajectory
• latent class growth mixture model

Acknowledgments

The authors are grateful to colleagues involved in the construction of the annual routine physical examinations database in Fuxin City and journal reviewers whose comments are greatly helpful for us to improve the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

LW and LR conducted the investigation, managed and analyzed the data, and wrote the original draft. YW and ZJ and RZ conducted the investigation. YS provided the data source. JL provided the data source and designed and supervised the present study. LZ managed and reviewed the project, wrote and revised the manuscript, and acquired funding support. All authors reviewed the manuscript and agree to be accountable for all aspects of the work.

Data availability statement

The data that support the findings of this study are available from the corresponding author LZ upon reasonable request.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under [Grant number 81872720]; the Shanghai Municipal Commission of Health and Family Planning under [Grant number 201840066]; and the Shanghai Committee of Science and Technology, China under [Grant number 19DZ2201000].