Trends of Elevated Blood Pressure Among Children and Adolescents: Data From the National Health and Nutrition Examination Survey 1988-2006

BACKGROUND: Elevated blood pressure (EBP) in children and adolescents increases future risk of cardiovascular disease. Among children and adolescents, increased weight is associated with EBP. METHODS: National cross-sectional data for children and adolescents aged 8-17 years from the National Health and Nutrition Examination Surveys (NHANESs): 1988-1994, 1999-2002, and 2003-2006. The main outcome measures were EBP and pre-EBP estimates. RESULTS: Overweight boys (odds ratio (OR) 1.54, confidence interval (CI) 1.11-2.13) and both obese boys and girls were significantly more likely to be classified as pre-EBP (boys, OR 2.81, CI 2.13-3.71; girls, OR 2.55, CI 1.75-3.73) and having EBP (boys aged 8-12 years, OR 6.06, CI 2.73-13.44, boys aged 13-17, OR 9.62 CI 4.86-19.06; girls, OR 2.33, CI 1.31-4.13) when compared to the reference weight and controlling for all other covariates.During 2003-2006, 13.6% (s.e. = 1.2) of boys aged 8-17 years and 5.7% (s.e. = 0.7) of the girls aged 8-17 years were classified as pre-EBP and 2.6% (s.e. = 0.5) of the boys aged 8-17 and 3.4% (s.e. = 0.7) of the girls aged 8-17 were having EBP. After controlling for age, race/ethnicity, and body mass index (BMI), girls only were significantly more likely to have EBP during 2003-2006 than during 1988-1994 (OR 2.17, CI 1.05-4.49). In contrast, adolescent boys aged 13-17 years were significantly less likely to be having EBP during 2003-2006 than during 1988-1994 (OR 0.32, CI 0.13-0.81). CONCLUSIONS: Obesity is strongly, positively, and independently associated with EBP and pre-EBP among youths. However, controlling for all covariates including BMI, EBP has increased among girls but decreased among adolescent boys aged 13-17, during 2003-2006 when compared with 1988-1994.