CVD risk higher in obese kids than previously thought

CVD risk higher in obese kids than previously thought
CVD risk higher in obese kids than previously thought

HealthDay News -- For school-aged children, cardiovascular disease risk parameters are worse for those who are overweight, and substantially worse for those who are obese compared with their normal-weight peers, results of a metaanalysis indicate.

Obesity significantly correlated with elevated systolic (P<0.001), diastolic (P<0.001) and 24-hour ambulatory systolic blood pressure (P=0.004) compared with normal weight, Claire Friedemann, a doctoral candidate at the University of Oxford in England, and colleagues reported in BMJ.

Obese children were also significantly more likely to have higher total cholesterol, triglycerides, insulin, insulin resistance and left ventricular mass, and lower high density lipoprotein (HDL) cholesterol than normal-weight children (P<0.001 for all), the researchers found.

Globally about 43 million children aged younger than 5 were considered overweight in 2010, according to background information in the article. Although overweight and obesity have been associated with CVD risk in adults, less is known about the effect of obesity on cardiovascular health in children.

So Friedemann and colleagues analyzed data from healthy children aged 5 to 15 years in 23 developed countries in order to describe the association between BMI category, sex, and CVD risk parameters. A total of 63 studies involving 49,220 children were included.

The researchers found that resting systolic blood pressure was 4.54 mm Hg higher in overweight (99% CI: 2.44- 6.64) and 7.49 mm Hg higher in obese children (99% CI: 3.36-11.62), compared with normal-weight children.

Similar associations were seen for diastolic and 24-hour ambulatory systolic blood pressure. The concentrations of all blood lipids were adversely affected by obesity.

In obese, but not overweight, participants, fasting insulin and insulin resistance were significantly higher. The left ventricular mass of obese children was significantly increased (19.12 g) compared with normal-weight children.

"Having a body mass index outside the normal range significantly worsens risk parameters for cardiovascular disease in school-aged children," the researchers wrote. "This effect, already substantial in overweight children, increases in obesity and could be larger than previously thought."

In an accompanying editorial, Lee Hudson, MBChB, and Russell Viner, PhD, both of the UCL Institute of Child Health in London, noted that early puberty was associated with both childhood obesity and increases in later cardiovascular risks.

"Opportunistic measurement of BMI and comorbidities related to obesity in primary care may be a useful first step in helping families move towards tackling childhood obesity," they wrote.


References

  1. Friedemann C et al. BMJ. 2012; 345: e4759.
  2. Hudson L,Viner RM. BMJ. 2012; 345: e5457.
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