Metabolic factors and parental blood pressure in relation to elevated blood pressure among Korean children and adolescents

Purpose Elevated blood pressure (EBP) in children and adolescents is a growing health problem frequently overlooked. This study aimed to explore the relationship between EBP in children and adolescents and their obesity levels, triglyceride-glucose index (TyG) indexes, and the blood pressure (BP) levels of their parents. Methods We conducted a cross-sectional analysis using national data from the Korea National Health and Nutrition Examination Survey (2007–2022). Pediatric EBP was defined according to the 2022 European Society of Cardiology guidelines. Multivariable logistic regression models were used to evaluate associations of overweight/obesity, TyG index, and parental BP status with pediatric EBP. Results A total of 5,158 participants aged 10–18 years and their parents were included. The prevalence of EBP was 9.9% in boys and 6.5% in girls. BP levels increased progressively across higher body mass index categories. Compared with non-overweight participants, overweight and obesity were associated with significantly higher odds of EBP (OR, 2.32; 95% CI, 1.87–2.93 and OR, 4.79; 95% CI, 3.51–6.45, respectively, all P < 0.05). Parental BP showed significant positive associations with offspring BP in both sexes. Compared with children without EBP in parents, offspring with maternal EBP, paternal EBP, or EBP in both parents had higher odds of EBP (OR: 2.78, 95% CI, 1.93–4.00; 1.70, 95% CI, 1.35–2.15; and 3.27, 95% CI, 1.98–5.41, respectively, all P < 0.05). Furthermore, BP levels increased with increasing TyG index. When the TyG index was >8.41, the TyG–SBP association was stronger above this threshold. Compared with the low TyG index group, moderate and high TyG indexes were associated with increased EBP risk (OR: 1.41, 95% CI, 1.08–1.84, and 3.40, 95% CI, 2.85–4.11, respectively, all P < 0.05). Conclusion Obesity, overweight, and high TyG index are associated with EBP in children and adolescents, and EBP in children and adolescents has a significant familial aggregation. These findings provide new insights into EBP prevention and control strategies for children and adolescents.