High blood pressure in children – the risk of excess weight

- Excess weight, a lack of exercise, poor diet, smoking – all these factors contribute to the development of arterial hypertension. While this was once considered a disease of middle and old age, new studies indicate that children and adolescents may also be increasingly affected.

A few years ago, childhood hypertension was considered rare and primarily a consequence of hormonal disorders and diseases of the kidneys and cardiovascular system. Now, however, it is increasingly being diagnosed in otherwise healthy children. The most likely causes are excess weight and obesity.

Swedish scientists recently published the results of a three-year study investigating the effect of weight loss on blood pressure in children with obesity. In the study, the researchers regularly monitored the blood pressure of more than 5,000 children with an average age of 10, who participated in a lifestyle change treatment programme.

At the start of the study, 15% of children showed increased systolic and approximately 5% increased diastolic blood pressure. The researchers used standard deviation scores (SDS) to measure the degree of obesity and changes in blood pressure, which indicate how a measured value relates to the mean value of a reference population. If the SDS is 0, the value corresponds to the mean of the reference population. Positive values, on the other hand, indicate that a measured value is above the mean, with negative values being below the mean. According to the WHO, children are considered to have overweight if their SDS for the BMI is above +1 and obesity if it exceeds +2.

The researchers were able to show that weight loss had a significant effect on systolic and diastolic blood pressure. As weight decreased, blood pressure also decreased. A reduction in BMI SDS of one standard deviation resulted in an average reduction in systolic blood pressure of 0.41 standard deviations, and a reduction of 0.26 standard deviations in diastolic blood pressure. In simple terms, weight reduction resulted in the blood pressure measurements of the subjects approaching the mean value for their age group. Children who already had hypertensive blood pressure values at the start of the study benefited the most from weight loss.

At the same time, the treatment was found to be inadequate in 27% of children. A weight gain of one standard deviation during the study period resulted in the risk of systolic hypertension almost doubling, while the risk of diastolic hypertension almost quadrupled.

Arterial hypertension is associated with no or only vague symptoms, such as concentration disorders, headaches, dizziness, nausea and impaired vision, especially in the early stages. In the longer term, however, it damages blood vessels and organs, meaning that heart disease and stroke can occur even in young adulthood.

For this reason, more and more people are calling for regular blood pressure and weight checks for children, especially those in high-risk groups such as children with excess weight or a genetic predisposition.

Hypertension can be treated effectively with diet and exercise if diagnosed early enough. Medication is only necessary for children in a few cases. Early blood pressure monitoring effectively counteracts the development of secondary diseases and is one of the most important foundations for ensuring long-term health.

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