Is Obesity a Predictor of High Blood Pressure in Children and Adolescents?

Obesity produces, among several negative consequences on health, increases in systolic and diastolic blood pressure. Currently, the heterogeneity of epidemiological studies does not permit us to conclude that high blood pressure (HBP) is increasing as a response to the obesity epidemic. However, when blood pressure (BP) is compared between non-obese and obese children or adolescents, both levels and prevalence of HBP are higher in obese individuals. Furthermore, it has been observed that changes in BMI directly alter BP: if the BMI increases, so too does BP, especially when this occurs in the first years of life or when the previous BMI was in the lowest deciles. Nevertheless, if BMI decreases, BP remains close to normal levels. Having obesity at any age is associated with an increased risk of experiencing HBP (OR: 1.5–4.4). The trends in BP in levels and prevalence are inconsistent among countries; however, with the obesity epidemic, it is possible to expect an upward trend, especially in systolic HBP. Thus, prevention of HBP should be supported also to prevent the occurrence of obesity. In addition, to ameliorate target organ damage and decrease the risk for future diseases, it is important to implement a systematic measurement and assessment of BP in pediatric offices following the guidelines of the Fourth Task Force Recommendations to decrease misdiagnosis.