(07-05-12) Adolescent Obesity is Associated with High Ambulatory Blood Pressure and Increased Carotid Intimal-Medial Thickness.

Stabouli S, Kotsis V, Papamichael C, Constantopoulos A, Zakopoulos N.

From Second Department of Pediatrics, "P. and A. Kyriakou" Children's Hospital, National and Kapodestrial University of Athens, Greece; and the Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodestrial University of Athens, Greece.

OBJECTIVES: To investigate 24-hour ambulatory blood pressure, lipid profiles, and carotid artery intimal-medial thickness (IMT) in adolescents with and without obesity. STUDY DESIGN: Ambulatory blood pressure data from 93 consecutive adolescents referred to our hypertension center for possible hypertension were analyzed. Fasting serum glucose and lipid concentrations were measured in all subjects. Carotid artery IMT was also measured by B-mode ultrasound imaging in all patients. Obesity was defined as body mass index >/=95(th) percentile for age and sex. Twenty-two of the subjects were obese and 71 nonobese. RESULTS: Mean 24-hour, daytime, and nighttime systolic blood pressures were significantly higher in obese subjects compared with nonobese subjects (P < .002). Twenty-four-hour, daytime, and nighttime pulse pressures were also significantly higher in obese subjects (P < .001). The magnitude of systolic white coat effect was significantly higher in obese subjects (P < .006) and white coat hypertension was significantly more frequent in obese subjects (P < .0001). Obese subjects had higher triglycerides (P < .001) and lower HDL cholesterol (P < .01) than nonobese subjects. Finally, obese adolescents had thicker mean IMT of internal carotid arteries than nonobese adolescents (P < .005). CONCLUSIONS: Obese adolescents have higher ambulatory blood pressure and higher carotid artery IMT, possibly indicating an early course of obesity-related hypertension and carotid artery structural alterations.

J Pediatr. 2005 Nov;147(5):651-6.

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