Systematic Evaluation of Adiposity Indices as Predictors of Hypertension Risk in Children and Adolescents

Objective To systemically examine the concomitant impact of adiposity indices on hypertension in children and adolescents. Methods A community-based cohort study by China Health and Nutrition Survey (2009-2011) included 262 children and adolescents aged 7-17. Anthropometric and lipid profiles were analyzed for hypertension risk using logistic and cross-lagged models. Results Of the 227 participants (mean age, 16.5 [2.3] years), 147 (53.9%) were boys. Over a two-year period, 26.4% developed hypertension, 5.3% had elevated systolic blood pressure (SBP), and 25.6% had elevated diastolic blood pressure (DBP). After adjusting for covariates, higher body mass index (BMI), waist circumference (WC), hip circumference (HC), triceps skinfold thickness (TST), and body roundness index (BRI) were associated with increased hypertension risk. Incorporating these measures into a BP-based model improved the AUC for hypertension prediction from 0.551 (95% CI: 0.463, 0.640) to 0.670 (95% CI: 0.592, 0.748). A longitudinal relationship were observed between these adiposity indices and hypertension symptoms. Conclusions The study suggests anthropometry parameters are superior to blood lipid indicators in predicting the occurrence of hypertension in children. Abdominal obesity, as indicated by WC, HC, and BRI, accounts for a significant portion of the risk for hypertension, particularly in children aged 7 to 12 years.