Waist-height ratio as an indicator of blood pressure alterations in obese paediatric patients

Ariada Guadalupe Lara Campos1, Aranza Lilian Perea Caballero1, Arturo Perea Martínez1, Lilia Mayrel
Santiago Lagunes1, Paul Tadeo Ríos Gallardo1
1National Institute of Pediatrics, Clinical Obesity and Non Communicable disease, México, Mexico


Objectives and Study:


To determine the strength of correlation between the waist-height ratio and blood pressure in obese patients. Descriptive, transversal, observational and retrospective study.




698 individuals between 5 and 18 years old who attended for the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any intercurrent pathology. The waist-height ratio (W/H ratio) was established at different parameters.
Blood pressure classification was according to The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Institutes of Health (NIH). The classification of the blood pressure was: prehypertension (90th to < 95th), stage 1 hypertension (95th to 99th) and stage 2 hypertension (> 99th) according to age, sex, and height. The blood pressure record for all children was between 8 to 10 am. Software IBM SPSS Statistics V.24.




The systemic blood pressure figures were found to be elevated in at least 12% of the cases in the W/H ratiostrata above 0.50, reaching higher percentages in the 0.65 – 0.69 stratum of the sample. The most significant number of patients showed blood pressure levels that placed them in the prehypertension group, that is, their blood pressure was between the 90th and 95th percentiles.

The results showed that arterial hypertension occurs at any age even in the absence of central obesity, however it is clear that in conditions of central obesity, the percentage of individuals with high blood pressure levels is higher, which suggests that Nutritional condition is one of the systemic conditions that contribute the most to develop states of systemic hypertension.





Hypertension is a public health problem, and obesity is becoming an epidemic,
increasing the risk of hypertension. Both are risk factors for cardiovascular diseases. Studies in children from India results in an adjusted risk ratio (95% CI) of high systolic blood pressure with W/H ratio was 2.48. The increase of a W/H ratio unit increases the risk of presenting hypertension 1.75 times in Mexican children. W/H ratio is a better predictor of elevated blood pressure compared to BMI and waist circumference in children followed over time.


In the present study, the W/H ratio value above 0.50 as a concept of central obesity, relates in a general way to a higher probability of presenting states of systemic hypertension, particularly in the range of prehypertension, so the importance of recording blood pressure should be reiterated. In all children and adolescents with central obesity.

Blood pressure alterations


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