Associations of general and abdominal obesity with high blood pressure among Lithuanian children and adolescents: a cross-sectional study

General and abdominal obesity are significant predictors of an increased risk of cardiovascular disease. The aim of the present study was to examine the associations of overweight/obesity and abdominal obesity, both independently and in combination, with high blood pressure (HBP), as well as to evaluate the ability of anthropometric parameters – the body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) – to predict HBP among Lithuanian children and adolescents aged 6–18 years. We analysed cross-sectional data from 2,656 children and adolescents aged 6 to 18 years who participated in the study between April and December 2024. Anthropometric parameters and blood pressure were measured. Multivariate logistic regression analysis was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals. The predictive ability of anthropometric parameters for HBP was assessed using the receiver operating characteristic (ROC) curve analysis. Overall, the prevalence of HBP was 20.2% (elevated BP: 11.0% and hypertension: 9.2%). The overall prevalence of overweight and obesity was 19.0% and 7.2%, respectively. The prevalence of abdominal obesity was 7.5% based on WC ≥ 90th percentile, and 11.5% based on WHtR ≥ 0.5. Overweight/obesity and abdominal obesity defined as WC ≥ 90th percentile and WHtR ≥ 0.5 were associated with increased odds of HBP (in boys, the aORs were 2.72, 5.32, and 2.96, respectively, and in girls, the aORs were 2.49, 4.43, and 3.39, respectively (all p < 0.001)). Significant associations were also observed between HBP and the combinations of overweight/obesity with WC < 90th percentile, overweight/obesity with WC ≥ 90th percentile, overweight/obesity with WHtR < 0.5, and overweight/obesity with WHtR ≥ 0.5 across both sexes (in boys, the aORs were 1.85 ( p = 0.001), 6.22, 2.04, and 3.54 (all p < 0.001), respectively; and in girls, the aORs were 1.96, 5.36, 1.99, and 4.13, respectively (all p < 0.001). WC and BMI demonstrated the highest AUCs in boys (0.792 and 0.781, respectively). Among Lithuanian schoolchildren aged 6–18 years, general and abdominal obesity, assessed both individually and in combination, were significantly associated with HBP. WC and BMI were better predictors of HBP than WHtR.