Skip to main content

Advertisement

SpringerLink
Log in

Childhood Obesity, Arterial Stiffness, and Prevalence and Treatment of Hypertension

  • Pediatric Congenital Heart Disease (G Singh, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Childhood obesity is associated with progressive vascular dysfunction as manifest by arterial stiffness and elevated blood pressure with associated subsequent morbidity and mortality because of early cardiovascular events including myocardial infarction and stroke in adulthood. Consequently, the recent dramatic increases in childhood obesity around the world present a hitherto unforeseen public health concern. While coordinated primary prevention efforts remain an ongoing important focus of action, identification and treatment of modifiable cardiovascular risk factors in pediatric patients is necessary given the existing burden of disease and future health consequences. Lifestyle interventions remain a cornerstone of our therapeutic approach, however, medical therapy is needed in some cases and should not be underutilized based on patient age. Herein, we discuss the relationship between childhood obesity and hypertension with a key emphasis on the evolution of adaptive and maladaptive vascular changes in the genesis of overt cardiovascular disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Abraham S, Collins G, Nordsieck M. Relationship of childhood weight status to morbidity in adults. HSMHA Health Rep. 1971;86(3):273–84.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  2. Sorof J, Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002;40(4):441–7.

    Article  PubMed  CAS  Google Scholar 

  3. Garell DC. The obese person as an adolescent. Calif Med. 1967;106(5):368–71.

    PubMed  CAS  PubMed Central  Google Scholar 

  4. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012;307(5):483–90.

    Article  PubMed  Google Scholar 

  5. Skinner AC, JA Skelton. Prevalence and Trends in Obesity and Severe Obesity Among Children in the United States, 1999–2012. JAMA Pediatr, 2014. This review provides the most recent prevalence of childhood obesity in the USA population, sampling data from 26 690 children over 14 years (1999–2012). The survey reveals that while obesity prevalence has increased during this time, more recent years show a levelling off, with the exception of an upward trend of more severe forms of obesity. This paper highlights the need for further studies addressing the factors impacting both positive and negative trends.

  6. Services, U.S.D.o.H.a.H. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics, 2004; 114(2 Suppl 4th Report): p. 555–76.

  7. Bucher BS, Ferrarini A, Weber N, Bullo M, Bianchetti MG, Simonetti GD. Primary hypertension in childhood. Curr Hypertens Rep. 2013;15(5):444–52.

    Article  PubMed  CAS  Google Scholar 

  8. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–e292.

    Article  PubMed  Google Scholar 

  10. Rosner B, Cook NR, Daniels S, Falkner B. Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988–2008. Hypertension. 2013;62(2):247–54.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Shi Y, de Groh M, Morrison H. Increasing blood pressure and its associated factors in Canadian children and adolescents from the Canadian Health Measures Survey. BMC Public Health. 2012;12(1):388.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Herouvi D, Karanasios E, Karayianni C, Karavanaki K. Cardiovascular disease in childhood: the role of obesity. Eur J Pediatr. 2013;172(6):721–32.

    Article  PubMed  Google Scholar 

  13. Spagnolo A, Giussani M, Ambruzzi AM, Bianchetti M, Maringhini S, Matteucci MC, et al. Focus on prevention, diagnosis and treatment of hypertension in children and adolescents. Ital J Pediatr. 2013;39:20.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Feber J, Ahmed M. Hypertension in children: new trends and challenges. Clin Sci (Lond). 2010;119(4):151–61.

    Article  Google Scholar 

  15. Ostchega Y, Carroll M, Prineas RJ, McDowell MA, Louis T, Tilert T. Trends of elevated blood pressure among children and adolescents: data from the National Health and Nutrition Examination Survey 1988–2006. Am J Hypertens. 2009;22(1):59–67.

    Article  PubMed  Google Scholar 

  16. Hansen ML, Gunn PW, Kaelber DC. Underdiagnosis of hypertension in children and adolescents. JAMA. 2007;298(8):874–9.

    Article  PubMed  CAS  Google Scholar 

  17. Yang Q, Zhang Z, Kuklina EV, Fang J, Ayala C, Hong Y, et al. Sodium intake and blood pressure among US children and adolescents. Pediatrics. 2012;130(4):611–9.

    Article  PubMed  Google Scholar 

  18. Chen JL, Wu Y. Cardiovascular risk factors in Chinese American children: associations between overweight, acculturation, and physical activity. J Pediatr Health Care. 2008;22(2):103–10.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kaess BM, Rong J, Larson MG, Hamburg NM, Vita JA, Levy D, et al. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA. 2012;308(9):875–81.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  20. Li Y, Yang X, Zhai F, Piao J, Zhao W, Zhang J, et al. Childhood obesity and its health consequence in China. Obes Rev. 2008;9 Suppl 1:82–6.

    Article  PubMed  Google Scholar 

  21. Strufaldi MW, Silva EM, Franco MC, Puccini RF. Blood pressure levels in childhood: probing the relative importance of birth weight and current size. Eur J Pediatr. 2009;168(5):619–24.

    Article  PubMed  Google Scholar 

  22. Juonala M, Viikari JS, Raitakari OT. Main findings from the prospective Cardiovascular Risk in Young Finns Study. Curr Opin Lipidol. 2013;24(1):57–64.

    Article  PubMed  CAS  Google Scholar 

  23. Hanevold C, Waller J, Daniels S, Portman R, Sorof J. The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics. 2004;113(2):328–33.

    Article  PubMed  Google Scholar 

  24. Litwin M, Niemirska A, Sladowska J, Antoniewicz J, Daszkowska J, Wierzbicka A, et al. Left ventricular hypertrophy and arterial wall thickening in children with essential hypertension. Pediatr Nephrol. 2006;21(6):811–9.

    Article  PubMed  Google Scholar 

  25. Koskinen J, Kahonen M, Viikari JS, Taittonen L, Laitinen T, Ronnemaa T, et al. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation. 2009;120(3):229–36.

    Article  PubMed  Google Scholar 

  26. Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.

    Article  PubMed  CAS  Google Scholar 

  27. Wilkinson IB, McEniery CM, Cockcroft JR. Arteriosclerosis and atherosclerosis: guilty by association. Hypertension. 2009;54(6):1213–5.

    Article  PubMed  CAS  Google Scholar 

  28. Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011;57(14):1511–22.

    Article  PubMed  Google Scholar 

  29. Cote AT, Harris KC, Panagiotopoulos C, Sandor GG, Devlin AM. Childhood Obesity and Cardiovascular Dysfunction. J Am Coll Cardiol. 2013;62(15):1309–19.

    Article  PubMed  Google Scholar 

  30. Aggoun Y, Szezepanski I, Bonnet D. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events in children. Pediatr Res. 2005;58(2):173–8.

    Article  PubMed  Google Scholar 

  31. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588–605.

    Article  PubMed  Google Scholar 

  32. Adji A, O'Rourke MF, Namasivayam M. Arterial stiffness, its assessment, prognostic value, and implications for treatment. Am J Hypertens. 2011;24(1):5–17.

    Article  PubMed  Google Scholar 

  33. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27. This study was the first to show arterial stiffness, measured as aortic pulse wave velocity, is a strong predictor of future CV events and all-cause mortality. This meta-analysis also found the predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk. This highlights the importance of early identification and intervention.

    Article  PubMed  Google Scholar 

  34. Koopman LP, McCrindle BW, Slorach C, Chahal N, Hui W, Sarkola T, et al. Interaction between myocardial and vascular changes in obese children: a pilot study. J Am Soc Echocardiogr. 2012;25(4):401–410 e1.

    Article  PubMed  Google Scholar 

  35. Nunez F, Martinez-Costa C, Sanchez-Zahonero J, Morata J, Chorro FJ, Brines J. Carotid artery stiffness as an early marker of vascular lesions in children and adolescents with cardiovascular risk factors. Rev Esp Cardiol. 2010;63(11):1253–60.

    Article  Google Scholar 

  36. Pandit D, Kinare A, Chiplonkar S, Khadilkar A, Khadilkar V. Carotid arterial stiffness in overweight and obese Indian children. J Pediatr Endocrinol Metab. 2011;24(1–2):97–102.

    PubMed  CAS  Google Scholar 

  37. Celik A, Ozcetin M, Yerli Y, Damar IH, Kadi H, Koc F, et al. Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars. 2011;39(7):557–62.

    Article  PubMed  Google Scholar 

  38. Harris KC, Al Saloos HA, De Souza AM, Sanatani S, Hinchliffe M, Potts JE, et al. Biophysical properties of the aorta and left ventricle and exercise capacity in obese children. Am J Cardiol. 2012;110(6):897–901.

    Article  PubMed  Google Scholar 

  39. Urbina EM, Kimball TR, Khoury PR, Daniels SR, Dolan LM. Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus. J Hypertens. 2010;28(8):1692–8.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  40. Pierce GL, Zhu H, Darracott K, Edet I, Bhagatwala J, Huang Y, et al. Arterial stiffness and pulse-pressure amplification in overweight/obese African-American adolescents: relation with higher systolic and pulse pressure. Am J Hypertens. 2013;26(1):20–6.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Jin Y, Chen Y, Tang Q, Xue M, Li W, Jiang J. Evaluation of carotid artery stiffness in obese children using ultrasound radiofrequency data technology. J Ultrasound Med. 2013;32(1):105–13.

    PubMed  Google Scholar 

  42. Iwashima S, Nakagawa Y, Ishikawa T, Satake SS, Nagata E, Ohzeki T. Abdominal obesity is associated with cardiovascular risk in Japanese children and adolescents. J Pediatr Endocrinol Metab. 2011;24(1–2):51–4.

    PubMed  Google Scholar 

  43. Polat TB, Urganci N, Caliskan KC, Akyildiz B. Correlation of abdominal fat accumulation and stiffness of the abdominal aorta in obese children. J Pediatr Endocrinol Metab. 2008;21(11):1031–40.

    Article  PubMed  Google Scholar 

  44. Pac FA, Guray Y, Polat TB. Wall motion velocities of ascending aorta measured by tissue Doppler imaging in obese children. Pediatr Int. 2010;52(5):778–84.

    Article  PubMed  Google Scholar 

  45. Ozcetin M, Celikyay ZR, Celik A, Yilmaz R, Yerli Y, Erkorkmaz U. The importance of carotid artery stiffness and increased intima-media thickness in obese children. S Afr Med J. 2012;102(5):295–9.

    PubMed  CAS  Google Scholar 

  46. Sakuragi S, Abhayaratna K, Gravenmaker KJ, O'Reill C, Srikusalanukul W, Budge MM, et al. Influence of adiposity and physical activity on arterial stiffness in healthy children: the lifestyle of our kids study. Hypertension. 2009;53(4):611–6. This investigation found BMI, waist circumference, and percentage of body fat, were all independently and positively associated with PWV (after adjusting for age, sex, and BP, P < 0.01 for all). This work highlights the effects of excess adiposity on arterial stiffening in healthy prepubescent children.

    Article  PubMed  CAS  Google Scholar 

  47. Niboshi A, Hamaoka K, Sakata K, Inoue F. Characteristics of brachial-ankle pulse wave velocity in Japanese children. Eur J Pediatr. 2006;165(9):625–9.

    Article  PubMed  Google Scholar 

  48. Dangardt F, Osika W, Volkmann R, Gan LM, Friberg P. Obese children show increased intimal wall thickness and decreased pulse wave velocity. Clin Physiol Funct Imaging. 2008;28(5):287–93.

    Article  PubMed  Google Scholar 

  49. Lurbe E, Torro I, Garcia-Vicent C, Alvarez J, Fernandez-Fornoso JA, Redon J. Blood pressure and obesity exert independent influences on pulse wave velocity in youth. Hypertension. 2012;60(2):550–5.

    Article  PubMed  CAS  Google Scholar 

  50. Charakida M, Jones A, Falaschetti E, Khan T, Finer N, Sattar N, et al. Childhood obesity and vascular phenotypes: a population study. J Am Coll Cardiol. 2012;60(25):2643–50.

    Article  PubMed  Google Scholar 

  51. Dangardt F, Chen Y, Berggren K, Osika W, Friberg P. Increased rate of arterial stiffening with obesity in adolescents: a five-year follow-up study. PLoS One. 2013;8(2):e57454. After initial testing did not reveal an impairment in PWV in children with obesity compared with controls, five years later in late adolescence, arterial stiffness was increased in obese youth. The increase in PWV and DBP was associated with baseline BMI z-score suggesting that obesity is a risk factor for arterial stiffness and hypertension, but the exact time-course of these developments is not known.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  52. Lee HY, Oh BH. Aging and arterial stiffness. Circ J. 2010;74(11):2257–62.

    Article  PubMed  Google Scholar 

  53. Sung J, Choi SH, Choi YH, Kim DK, Park WH. The relationship between arterial stiffness and increase in blood pressure during exercise in normotensive persons. J Hypertens. 2012;30(3):587–91.

    Article  PubMed  CAS  Google Scholar 

  54. Dernellis J, Panaretou M. Aortic stiffness is an independent predictor of progression to hypertension in nonhypertensive subjects. Hypertension. 2005;45(3):426–31.

    Article  PubMed  CAS  Google Scholar 

  55. Najjar SS, Scuteri A, Shetty V, Wright JG, Muller DC, Fleg JL, et al. Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore Longitudinal Study of Aging. J Am Coll Cardiol. 2008;51(14):1377–83.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959–71.

    Article  PubMed  CAS  Google Scholar 

  57. Dias RG, Gowdak MM, Pereira AC. Genetics and cardiovascular system: influence of human genetic variants on vascular function. Genes Nutr. 2011;6(1):55–62.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  58. Franklin SS. Arterial stiffness and hypertension: a two-way street? Hypertension. 2005;45(3):349–51.

    Article  PubMed  CAS  Google Scholar 

  59. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Invitti C, et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009;27(9):1719–42.

    Article  PubMed  CAS  Google Scholar 

  60. Assadi F. The growing epidemic of hypertension among children and adolescents: a challenging road ahead. Pediatr Cardiol. 2012;33(7):1013–20.

    Article  PubMed  Google Scholar 

  61. Juhola J, Oikonen M, Magnussen CG, Mikkila V, Siitonen N, Jokinen E, et al. Childhood physical, environmental, and genetic predictors of adult hypertension: the cardiovascular risk in young Finns study. Circulation. 2012;126(4):402–9.

    Article  PubMed  Google Scholar 

  62. Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res. 2005;13(1):163–9.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ. 2012;345:e4759.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Kuczmanski R, Ogden C, Grummer-Strawn L, Flegal K, Guo S, Wei R, et al. CDC Growth Charts: United States, in Advanced data from vital and health statistics; no. 3142000, National Centre for Health Statistics: Hyattsville, MD.

  65. Hofman A, Valkenburg HA, Maas J, Groustra FN. The natural history of blood pressure in childhood. Int J Epidemiol. 1985;14(1):91–6.

    Article  PubMed  CAS  Google Scholar 

  66. Malcolm DD, Burns TL, Mahoney LT, Lauer RM. Factors affecting left ventricular mass in childhood: the Muscatine Study. Pediatrics. 1993;92(5):703–9.

    PubMed  CAS  Google Scholar 

  67. Kavey RE. Left ventricular hypertrophy in hypertensive children and adolescents: predictors and prevalence. Curr Hypertens Rep. 2013;15(5):453–7.

    Article  PubMed  CAS  Google Scholar 

  68. de Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitiis O, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol. 1992;20(5):1251–60.

    Article  PubMed  Google Scholar 

  69. Seeman T, Pohl M, Palyzova D, John U. Microalbuminuria in children with primary and white-coat hypertension. Pediatr Nephrol. 2012;27(3):461–7.

    Article  PubMed  Google Scholar 

  70. Willi SM, Hirst K, Jago R, Buse J, Kaufman F, El Ghormli L, et al. Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial. Pediatr Obes. 2012;7(3):230–9. This paper highlights the importance of changing school environment with regards to nutrition and physical activity and demonstrates the importance of education and positive reinforcement to decrease levels of hypertension in the teenage population.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  71. Mikkila V, Rasanen L, Laaksonen MM, Juonala M, Viikari J, Pietinen P, et al. Long-term dietary patterns and carotid artery intima media thickness: the Cardiovascular Risk in Young Finns Study. Br J Nutr. 2009;102(10):1507–12.

    Article  PubMed  CAS  Google Scholar 

  72. Shay CM, Ning H, Daniels SR, Rooks CR, Gidding SS, Lloyd-Jones DM. Status of cardiovascular health in US adolescents: prevalence estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005–2010. Circulation. 2013;127(13):1369–76.

    Article  PubMed  Google Scholar 

  73. Couch SC, Saelens BE, Levin L, Dart K, Falciglia G, Daniels SR. The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. J Pediatr. 2008;152(4):494–501.

    Article  PubMed  Google Scholar 

  74. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.

    Article  PubMed  Google Scholar 

  75. Daniels SR, Pratt CA, Hayman LL. Reduction of risk for cardiovascular disease in children and adolescents. Circulation. 2011;124(15):1673–86.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Knowles G, Pallan M, Thomas GN, Ekelund U, Cheng KK, Barrett T, et al. Physical activity and blood pressure in primary school children: a longitudinal study. Hypertension. 2013;61(1):70–5.

    Article  PubMed  CAS  Google Scholar 

  77. Guerra PH, Nobre MR, da Silveira JA, Taddei JA. The effect of school-based physical activity interventions on body mass index: a meta-analysis of randomized trials. Clinics (Sao Paulo). 2013;68(9):1263–73.

    Article  Google Scholar 

  78. Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: a meta-analysis. CMAJ. 2009;180(7):719–26.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Gopinath B, Hardy LL, Kifley A, Baur LA, Mitchell P. Activity Behaviors in Schoolchildren and Subsequent 5-yr Change in Blood Pressure. Med Sci Sports Exerc. 2014;46(4):724–9.

    Article  PubMed  Google Scholar 

  80. Saunders TJ, Tremblay MS, Mathieu ME, Henderson M, O'Loughlin J, Tremblay A, et al. Associations of sedentary behavior, sedentary bouts and breaks in sedentary time with cardiometabolic risk in children with a family history of obesity. PLoS One. 2013;8(11):e79143.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Kalarchian MA, Levine MD, Arslanian SA, Ewing LJ, Houck PR, Cheng Y, et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics. 2009;124(4):1060–8.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Sbruzzi G, Eibel B, Barbiero SM, Petkowicz RO, Ribeiro RA, Cesa CC, et al. Educational interventions in childhood obesity: A systematic review with meta-analysis of randomized clinical trials. Prev Med. 2013;56(5):254–64.

    Article  PubMed  Google Scholar 

  83. Meyer AA, Kundt G, Lenschow U, Schuff-Werner P, Kienast W. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. J Am Coll Cardiol. 2006;48(9):1865–70.

    Article  PubMed  Google Scholar 

  84. Lee YH, Song YW, Kim HS, Lee SY, Jeong HS, Suh SH, et al. The effects of an exercise program on anthropometric, metabolic, and cardiovascular parameters in obese children. Korean Circ J. 2010;40(4):179–84.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  85. Li JS, Barnett TA, Goodman E, Wasserman RC, Kemper AR. Approaches to the prevention and management of childhood obesity: the role of social networks and the use of social media and related electronic technologies: a scientific statement from the American Heart Association. Circulation. 2013;127(2):260–7.

    Article  PubMed  Google Scholar 

  86. Williamson DA, Walden HM, White MA, York-Crowe E, Newton Jr RL, Alfonso A, et al. Two-year internet-based randomized controlled trial for weight loss in African-American girls. Obesity (Silver Spring). 2006;14(7):1231–43.

    Article  Google Scholar 

  87. Chaturvedi S, Lipszyc DH, Licht C, Craig JC, Parekh R. Pharmacological interventions for hypertension in children. Cochrane Database Syst Rev. 2014;2:CD008117. This systemic review summarizes the current evidence for the reader on anithypertensive medications for children with hypertension for those who have persistent hypertension despite intervention with lifestyle modification

    PubMed  Google Scholar 

  88. Yoon EY, Cohn L, Rocchini A, Kershaw D, Freed G, Ascione F, et al. Antihypertensive prescribing patterns for adolescents with primary hypertension. Pediatrics. 2012;129(1):e1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33(5):386–93.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Kathryn R. Armstrong, Dr. Anita T. Cote, Dr. Angela M. Devlin, and Dr. Kevin C. Harris each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Division of Cardiology, BC Children’s Hospital, Children’s Heart Centre, 1F–4480 Oak Street, Vancouver, BC, V6H 3 V4, Canada

    Kathryn R. Armstrong MD & Kevin C. Harris MD, MHSc

  2. Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, BC, Canada

    Anita T. Cote PhD, Angela M. Devlin PhD & Kevin C. Harris MD, MHSc

Authors
  1. Kathryn R. Armstrong MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anita T. Cote PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angela M. Devlin PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kevin C. Harris MD, MHSc
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin C. Harris MD, MHSc.

Additional information

Kathryn R. Armstrong and Anita T. Cote: Authors contributed equally.

This article is part of the Topical Collection on Pediatric Congenital Heart Disease

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Armstrong, K.R., Cote, A.T., Devlin, A.M. et al. Childhood Obesity, Arterial Stiffness, and Prevalence and Treatment of Hypertension. Curr Treat Options Cardio Med 16, 339 (2014). https://doi.org/10.1007/s11936-014-0339-9

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11936-014-0339-9

Keywords

Search

Navigation