Anthropometric indices of obesity as predictors of high blood pressure among school children

ABSTRACT

Background

Hypertension is related to increased body fat, which can be evaluated by anthropometric indicators. The aim of this study was to determine the predictive power of anthropometric indicators and to establish their cutoff points as discriminators of high blood pressure.

Methods

A cross-sectional study was conducted on 793 schoolchildren aged 10–14 years. Six anthropometric indices were used: body mass index-z-score (BMI-z-score), waist circumference (WC), waist-toheight ratio (WHtR), a body shape index (ABSI), body roundness index (BRI) and conicity index (CI). Elevated blood pressure (EBP) and hypertension (HTN) were characterized by values ≥ 90th and <95th percentile and ≥ 95th percentile for systolic and/or diastolic blood pressure, respectively. The predictive power of anthropometric indices was analyzed by sex using the receiver operating characteristic curve (ROC).

Results

The prevalence of EBP and HTN was 11.0% and 14.8%, respectively. According to the analyses of the ROC curve, WC provided the largest area under the curve (AUC) value, while CI showed the lowest AUC value in predicting elevated blood pressure in the total sample. The BMI z-score provided the largest area under the curve (AUC) value (0.722), followed by WHtR (0.709) and BRI (0.709), in predicting hypertension in boys.

Conclusions

BMI z-score and WC may be the best predictors of EBP and BMI z-score for HTN among Jordanian schoolchildren.

KEYWORDS:

• Obesity
• anthropometric indices
• schoolchildren
• high blood pressure
• prediction

Acknowledgments

The authors would like to thank students and their parents for taking part in this study. The authors would also like to thank the headmasters of schools for their permission to perform this study.

Authors contributions

H A contributed to data collection, writing the first draft, and data analysis. B Alkhatib contributed to data collection and revision of the manuscript

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the 1964 Declaration of Helsinki.

The Institutional Review Board of The Hashemite University approved the protocol of the present study (No. 9/6/2017/2018). The study included only students who voluntarily agreed to participate and whose parents signed the informed consent form authorizing their involvement.

Additional information

Funding

There were no external funding sources for this study.