Study of obesity and hypertension in adolescents and their relationship with anthropometric indices

Kritika Malhotra, R. H. Nistane


Background: Childhood obesity and hypertension are on the rise. Obesity leads to many complications like type 2 diabetes mellitus, polycystic ovaries, cancers, etc. Diagnosis of obesity is by various anthropometric indices, some not so accurate. Hence, this warrants intensive studies of these indices in relation with obesity and hypertension. This study was undertaken prevalence of obesity and hypertension in adolescents and its relationship with anthropometric indices and to study the waist-circumference-by-height ratio and its relationship with obesity.

Methods: This prospective, cross-sectional, observational study was conducted in Department of Pediatrics, Dr. Panjabrao Deshmukh Medical College and Hospital, Amravati, Maharashtra, India and data was collected from urban secondary schools of Amravati from 450 adolescents between ages 12-17years, selected randomly, with the help of preformed questionnaires. Anthropometric measurements were taken to calculate BMI, waist circumference and skin- fold thickness and blood pressure taken. Data was analyzed using WHO and teacher-made scales and statistically using contingency coefficient.

Results: Out of 450, prevalence of overweight was 19.1% (86) and obesity was 10.7% (48). Out of 48 obese, 32 were males. Prevalence of obesity was significantly higher among adolescents who had physical activity of ≤3hours/week and who watch TV and/or use computer for >2hours/day. Out of 194 adolescents who had normal BMI, 20 (26.3%) had central obesity. 29 (6.4%) had hypertension, 11 (37.9%) of them were obese.

Conclusions: The prevalence of primary hypertension among adolescents has increased, largely due to the childhood obesity epidemic and thus, steps should be taken to curb both these demons at the earliest. Waist-circumference-to-height ratio should be used more than other indices as it detects central obesity and related cardio-metabolic risk among normal-weighted children.


Obesity, Hypertension, Adolescents, Anthropometry

Full Text:



William H. Dietz. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101:518-25.

Gahagan S. Overweight and Obesity. In: RM Kliegman, BF Stanton, JW St. Geme, RE Behrman, NF Schor (ed.). Nelson Textbook of Pediatrics. Nineteenth Edi: Philadelphia. W.B. Sanders. 2012:181-186.

Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL. Overweight prevalence and trends for children and adolescents: the National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolescent Med. 1995;149(10):1085-91.

Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics. 1998;101(3):497-504.

Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(3):518-25.

Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increased incidence of non–insulin-dependent diabetes mellitus among adolescents. J Pediatr. 1996;128(5.1):608-15.

Amiel SA, Sherwin RS, Simonson DC, Lauritano AA, Tamborlane WV. Impaired insulin action in puberty: a contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med. 1986;315(4):215-9.

Bloch CA, Clemons P. Sperling MA. Puberty decreases insulin sensitivity. J Pediatr. 1987;110(3):481-7.

Goran MI, Gower BA. Longitudinal study on pubertal insulin resistance. Diabetes. 2001;50:2444-50.

Ten S, Maclaren N. Insulin resistance syndrome in children. The Journal of Clinical Endocrinology & Metabolism. 2004;89(6):2526-39.

Freedman DS, Wang J, Ogden CL. The prediction of body fatness by BMI and skinfold thickness among children and adolescents. Annals of Human Biology. 2007;34(2):183-94.

Sardinha LB, Going SB, Teixeira PJ, Lohman TG. Receiver operating characteristic analysis of body mass index, triceps skinfold thickness and arm girth for obesity screening in children and adolescents. The American Journal of Clinical Nutrition. 1999.70(6):1090-5.

Williams DP, Going SB, Lohman TG. Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. American Journal of Public Health. 1992;82(3):358-63.

Dwyer T, Blizzard CL. Defining obesity in children by biological endpoint rather than population distribution. International Journal of Obesity and Related Metabolic Disorder. 1996;20(5):472-80.

Mueller WH, Harrist RB, Doyle SR. Percentiles of body composition from bioelectrical impedance and body measurements in US adolescents 8–17 years old: Project Heart Beat! Am J Hum Biol. 2004;16:135-50.

Garbin CP. Bivariate Correlation Analyses and Comparisons; Cal’s Computator Program. (Accessed on 13 July 2013).

Ashwell M. Waist to height ratio and the Ashwell shape chart could predict risks of obesity in adults and children in all ethnic groups. Nutr Food Sci. 2005;36:359-64.

Bagga A, Jain R, Vijaykumar M, Kanitkar M, Ali. Evaluation and management of hypertension. Indian Pediatric. 2007;44:103-21.

Anjana, Prabhjot, Kaur N, Kumari K, Sidhu S. Variation in blood pressure among school children of Amritsar (Punjab). Anthropologist. 2005;7:201-4.

Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. The New England journal of medicine. 2011;365(20):1876-85.

WHO. What is overweight and obesity? Available from: childhood_what/en/. Accessed on 20 July 2013.

Tharkar S, Viswanathan V. Impact of socioeconomic status on prevalence of overweight and obesity. The Open Obesity Journal. 2009;1:9-14.

Kumar S, Mahabalaraju DK, Anuroopa MS. Prevalence of obesity and its influencing factor among affluent school children of Davangere city. Indian Journal of Community Medicine. 2007;32:15-7.

Laxmaiah A, Balakrishna N, Kamasamudram V Mohanan N. Factors affecting prevalence of overweight among 12 to 17 year old urban adolescents in Hydrabad, India. Obesity. 2007;15(6):1384-90.

Bharati DR, Deshmukh PR, Garg BS. Correlates of overweight and obesity among school going children of Wardha city, Central India. Indian Journal Medical Research. 2008;127(6):539-43.

Kotian MS, Kumar SG, Kotian SS. Prevalence and determinants of overweight and obesity among adolescent school children of South Karnataka, India. Indian Journal of Community Medicine. 2010;35(1):176-8.

Panjikkaran ST, Kumari K S. Augmenting BMI and waist-height ratio for establishing more efficient obesity percentiles among school-going children. Indian Journal of Community Medicine. 2009;34(2):135-9.

Narayanappa D, Rajani HS. Prevalence of prehypertension and hypertension among urban and rural school going children. Indian Pediatrics. 2012.49(9):755-6.

Buch N, Goyal JP, Kumar N, Parmar I. Prevalence of hypertension in school going children of Surat city, J Cardiovasc Dis Res. 2011;2(4):228-32.

Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Sood NK, et al. Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J. 2004;56:310-4.