The Evaluation of Waist Circumference and Waist-Hip Ratio as Predictors of Hypertension in Children

Abstract

Background: Childhood hypertension is a public health concern because of associated cardio-metabolic morbidities in adulthood. Overweight and obesity are main drivers and predictors of childhood hypertension. There is paucity of studies on waist circumference (WC) and waist-hip ratio (WHR) – measures of central obesity - as predictors of hypertension in children. The study was done to determine if WC and WHR predicts hypertension in children. Study Design:  The study was a descriptive cross-sectional study. Place and Duration of Study: Primary schools in Owerri Municipal Local Government Area (LGA), Imo State, Nigeria between September 2017 to April 2018. Methodology: 809 school children aged 6-12 years were recruited from three public and six private primary schools using multi-staged sampling method. Their blood pressure (BP), weight, height, hip circumference and WC were measured using standard techniques. The BMI and WHR were then calculated. Central obesity was defined as WC ≥90th percentile. The data were analyzed with IBM-SPSS 21. Results: The male female ratio was 1:1. The prevalence of pre-hypertension and hypertension were 8.50% and 2.70% respectively. While those of overweight, obesity and central obesity were 5.10%, 5.90% and 10.10% respectively. WC significantly and positively correlated with systolic blood pressure (SBP) [r = 0.57, p = 0.0001] and diastolic blood pressure (DBP) [r = 0.57, p = 0.0001]. WHR had a negative correlation with SBP and DBP [r = -0.33, p = 0.0001 in both cases]. Central obesity increased the odds of developing systolic and diastolic prehypertension/ hypertension by 9 and 8 folds respectively. Conclusion: Central obesity predicted prehypertension/hypertension in primary school children in this study and therefore can be used as screening tool in programs to prevent childhood obesity and hypertension.