Association between waist-to-height ratio and elevated blood pressure in children: A cross-sectional study

Abstract

Paediatric hypertension is an emerging public health concern, with childhood elevated blood pressure (BP) known to track into adulthood. Obesity, particularly central obesity, plays a vital role in the development of adverse BP patterns in children. Waist-to-height ratio (WHtR) has outshone as a simple and age-independent marker of central obesity, potentially useful for identifying children at risk of elevated BP. The objective of the study is to estimate the occurrence of elevated BP and hypertension in children with high WHtR. This is a cross-sectional study. Paediatrics inpatient ward of Employees’ State Insurance Corporation Medical College and Post Graduate Institute of Medical Science and Research Hospital, Rajajinagar, Bangalore, India. All children aged 6 years -17 years. All 186 eligible participants’ anthropometry was checked which included height, weight, body mass index and WHtR. Children with a WHtR of ≥0.5 were considered to have high WHtR. Systolic BP and/or diastolic BP of ≥90 th and <95 th centile for <13 years old and 120– 129/<80 mmHg for adolescents >13 years old was considered as elevated BP. All the anthropometric measures were then analysed by age, gender and height-specific Indian Academy of Paediatrics percentile charts. A total of 186 children were studied, with a mean age of 11.5 ± 3.2 years (range 6–17 years). High WHtR (≥0.5) was observed in 30 children (16.1%), while 27 children (14.5%) were found to have elevated BP. Elevated BP was present in 30% ( n = 9) of children with high WHtR compared to 11.5% ( n = 18) among those with WHtR <0.5. Children with high WHtR had a higher risk of having elevated BP (relative risk = 2.6, 95% confidence interval 1.30–5.26); this association was statistically significant (χ 2 = 6.91; p = 0.0085). High WHtR and elevated BP were observed in a notable proportion of children. WHtR may serve as a simple screening tool for identifying children at potential cardiometabolic risk, warranting further evaluation in larger longitudinal studies.