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Question

Is there a link between childhood obesity and high blood pressure?

Juan C. Kupferman, MD, MPH, FAAP

Answer

Obesidad y presión arterial en niños hispanos

Yes, children and adolescents with overweight and obesity are frequently diagnosed with hypertension (high blood pressure). However, in these cases, hypertension can be controlled and even cured.

High blood pressure can lead to serious long-term heart and blood vessel diseases that can put your child's life at risk. That's why it's so important to get your child's blood pressure under control.

Let me tell you about one of my patients who had hypertension-associated obesity, and how it was successfully treated.

Jorge's story

Jorge, a 10-year-old boy, came to my office with his mother because he had high blood pressure that was detected at his annual preventive health visit. Jorge didn't have any symptoms, but he seemed a little nervous, like most children who see a doctor for the first time. Jorge was overweight by about 22 pounds, in addition to being sedentary, playing a lot of video games, and having a family history of high blood pressure. After waiting for Jorge to calm down and get comfortable, I took his blood pressure. It was high, above the maximum normal values for his age, height and sex.

Blood pressure can stay elevated for a little while when someone gets nervous. So, I decided to confirm Jorge's blood pressure with an out-of-office test called ambulatory blood pressure monitoring. For 24 hours, a portable monitor records the child's blood pressure at home, at school and even while they're sleeping. This type of monitoring, recommended by the American Academy of Pediatrics, showed that Jorge had high blood pressure even outside the office for much of the day and night.

How is hypertension associated with obesity treated in children?

For kids with hypertension associated with obesity, it is first recommended to lose weight. This is best achieved by eating foods low in calories and sodium (salt) and getting more physical activity and exercise. Pediatricians may also connect families with a dietitian or nutritionist who can offer guidance to help families to follow these recommendations.

If your child's blood pressure doesn't improve with weight loss and exercise, medications can be used to control their blood pressure.

Jorge's treatment

My initial recommendation for Jorge was to lose weight, improve his diet and get more exercise. I also had to prescribe medication to control his blood pressure. For several years, Jorge was unable to lose weight, and we had to control his blood pressure with medication. When he turned 16, Jorge set out to lose weight, started eating healthier, cut out sugary drinks and started exercising.

Today, Jorge is 18 years old. He managed to drop his weight from 254 pounds the previous year to a current weight of 187 pounds—an impressive reduction of 66 pounds. Jorge's blood pressure, controlled since childhood with medication, improved significantly.

Little by little we lowered the dose of his medication until finally, we were able to stop it. Jorge proved to himself that it is possible to control his weight and normalize his blood pressure, a difficult but possible achievement.

More information

Juan C. Kupferman, MD, MPH, FAAP

Juan C. Kupferman, MD, MPH, FAAP received his medical degree from the University of Buenos Aires ​School of Medicine in Argentina and his Master's degree in Public Health from Columbia University in New York. He is board certified in general pediatrics and pediatric nephrology and is a professor of pediatrics at Albert Einstein College of Medicine. Dr. Kupferman is also the co-editor of the Spanish versions of the AAP publications, Caring for Your Baby and Toddler, Third Edition and Second Edition of Your Baby's First Year.

Last Updated
10/25/2022
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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