Blood Pressure Differences among Obese, Overweight, and Normal-Weight Adolescents in Enugu Metropolis: A Comparative Study

Background: Hypertension is a major modifiable cardiovascular risk factor, and increasing adolescent obesity is strongly linked to early-onset hypertension and an increased risk of cardiovascular complications in adults. This study compared blood pressure among obese, overweight, and normal-weight adolescents and examined associated anthropometric factors and patterns. Methodology: This comparative cross-sectional study included 486 adolescents (162 normal-weight, 162 overweight, and 162 obese) from secondary schools in Enugu. The participants were selected via multistage sampling. Anthropometric and blood pressure measurements were obtained via standardized methods, with blood pressure classified by age-, sex-, and height-specific percentiles. The data were analysed via SPSS v26, with significance set at p < 0.05. Results: A significant association was observed between body weight and hypertension (χ² = 45.5, p = 0.0001), with the prevalence increasing from 3.7% in normal-weight participants to 12.3% in overweight participants and 38.9% in obese participants. Both systolic and diastolic blood pressure differed significantly across the groups (p = 0.0001). Systolic blood pressure increased progressively across all categories (p < 0.05), whereas diastolic blood pressure was significantly greater in obese participants. Significant positive correlations were found between blood pressure and anthropometric indices, particularly in the overweight and obese groups (p < 0.05). Hypertensive participants had significantly higher systolic blood pressure across all groups, with obese hypertensive participants also having higher diastolic pressure. Conclusion: This study demonstrated that obesity is strongly associated with an increased risk of elevated blood pressure among adolescents. Blood pressure increases progressively with increasing body weight, with obese adolescents being disproportionately affected. Waist circumference has emerged as a key predictor of elevated blood pressure, underscoring the importance of central adiposity in cardiovascular risk stratification. These findings highlight the growing burden of obesity-related elevated blood pressure in adolescents and the need for early detection and intervention.