Blood Pressure Differences among Obese, Overweight, and Normal-Weight Adolescents in Enugu Metropolis: A Comparative Study
Main Article Content
Keywords
Adolescents, obesity, overweight, hypertension, blood pressure, waist circumference
Abstract
Background: Hypertension is a major modifiable cardiovascular risk factor, and increasing adolescent obesity is strongly linked to early-onset hypertension and an increased risk of cardiovascular complications in adults. This study compared blood pressure among obese, overweight, and normal-weight adolescents and examined associated anthropometric factors and patterns.
Methodology: This comparative cross-sectional study included 486 adolescents (162 normal-weight, 162 overweight, and 162 obese) from secondary schools in Enugu. The participants were selected via multistage sampling. Anthropometric and blood pressure measurements were obtained via standardized methods, with blood pressure classified by age-, sex-, and height-specific percentiles. The data were analysed via SPSS v26, with significance set at p < 0.05.
Results: A significant association was observed between body weight and hypertension (χ² = 45.5, p = 0.0001), with the prevalence increasing from 3.7% in normal-weight participants to 12.3% in overweight participants and 38.9% in obese participants. Both systolic and diastolic blood pressure differed significantly across the groups (p = 0.0001). Systolic blood pressure increased progressively across all categories (p < 0.05), whereas diastolic blood pressure was significantly greater in obese participants. Significant positive correlations were found between blood pressure and anthropometric indices, particularly in the overweight and obese groups (p < 0.05). Hypertensive participants had significantly higher systolic blood pressure across all groups, with obese hypertensive participants also having higher diastolic pressure.
Conclusion: This study demonstrated that obesity is strongly associated with an increased risk of elevated blood pressure among adolescents. Blood pressure increases progressively with increasing body weight, with obese adolescents being disproportionately affected. Waist circumference has emerged as a key predictor of elevated blood pressure, underscoring the importance of central adiposity in cardiovascular risk stratification. These findings highlight the growing burden of obesity-related elevated blood pressure in adolescents and the need for early detection and intervention.
References
Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 2009; 6:e1000058. [DOI] [PMC free article] [PubMed] [Google Scholar]
Papka NY, Babaniyi IB, Aikhionbare HA, Oladele JT, Chinawa JM. Blood Pressure Pattern and Prevalence of Hypertension amongst Apparently Healthy Primary School Pupils in Abuja, Nigeria. Niger Postgrad Med J. 2024 Apr 1;31(2):111-117. doi: 10.4103/npmj.npmj_254_23.
Hao G, Wang X, Treiber FA, Harshfield G, Kapuku G, Su S. Blood pressure trajectories from childhood to young adulthood associated with cardiovascular risk: results from the 23-year longitudinal Georgia Stress and Heart Study. Elevated blood pressure 2017; 69:435–442. [DOI] [PMC free article] [PubMed] [Google Scholar]
Shen W, Zhang T, Li S, Zhang H, Xi B, Shen H, Fernandez C, Bazzano L, He J, Chen W. Race and sex differences of long-term blood pressure profiles from childhood and adult elevated blood pressure: the Bogalusa Heart Study. Elevated blood pressure 2017; 70:66–74. [DOI] [PMC free article] [PubMed] [Google Scholar]
Okafor HU, Mbanefo N, Muoneke V, Odetunde IO, Uwaezuoke SN, Agu G, et al. Trends, causes and outcomes of Acute Kidney Injury (AKI) among children attending University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu. Afri Health Sci. 2024;24(2). 427-436. [https://dx.doi.org/10.4314/ahs.v24i2.43](https://dx.doi.org/10.4314/ahs.v24i2.43)
Jackson SL, Zhang Z, Wiltz JL, Loustalot F, Ritchey MD, Goodman AB, Yang Q. Elevated blood pressure among youths—United States, 2001–2016. MMWR Morb Mortal Wkly Rep 2018; 67:758–762. [DOI] [PMC free article] [PubMed] [Google Scholar]
Daniel RA, Haldar P, Prasad M, Kant S, Krishnan A, Gupta SK, Kumar R. PLoS One. 2020;15 doi: Prevalence of elevated blood pressure among adolescents (10-19 years) in India: a systematic review and meta-analysis of cross-sectional studies. 10.1371/journal.pone.0239929. [DOI] [PMC free article] [PubMed] [Google Scholar]
India National Family Health Survey 2019-21 (FR375) [https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf](https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf) 2022;2019:1. [Google Scholar]
Oduwole, A.A., Ladapo, T.A., Fajolu, I.B. et al. Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study. BMC Public Health 12, 616 (2012). [https://doi.org/10.1186/1471-2458-12-616](https://doi.org/10.1186/1471-2458-12-616)
Chinawa JM, Obu HA, Manyike PC, Obi IE, Odetunde OI, Chinawa AT. Self-Esteem among Adolescents in Nigerian Secondary Schools: A Neglected Issue. British Journal of Medicine & Medical Research 5: 98-106, 2015
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of elevated blood pressure prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation, 134 (2016), pp. 441-450
Tain YL, Hsu CN. Kidney programming and elevated blood pressure: linking prenatal development to adulthood. Int J Mol Sci, 25 (2024), Article 13610
Janis M. Dionne, Evidence Gaps in the Identification and Treatment of Elevated Blood Pressure in Children, Canadian Journal of Cardiology, Volume 36, Issue 9, 2020, Pages 1384-1393,
Chinawa JM, Chinawa AT. Assessment of primary health care in a rural health centre in Enugu, South-East Nigeria. Pak J Med Sci. 2015 Jan-Feb;31(1):60-4. doi: 10.12669/pjms.311.6360. PMID: 25878615; PMCID: PMC4386158.
Reddy BM, Ganguly E, Sharma PK. Elevated blood pressure and its Correlates in the Oldest Old Population Aged 80 Years and Above in Urban South India. J Gerontol Geriatr Res. 2018;7(3):472. doi: 10.4172/2167-7182.1000472. Epub 2018 May 31. PMID: 29984116; PMCID: PMC6035005.
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet. 2017 Jan 07;389(10064):37-55.
Lwanga S, Lemeshow S, World Health Organization. Sample size determination in health studies: a practical manual. Available from [https://apps.who.int/iris/handle/10665/40062](https://apps.who.int/iris/handle/10665/40062). Accessed October 2021.
Sample size: Stratified sample- Stat Trek. [Online] Available from [https://stattrek.com>sample-size>stratified-sample.aspx](https://stattrek.com>sample-size>stratified-sample.aspx). Accessed on 14/1/2023
National Health and Nutrition Examination Survey. Anthropometry Procedures Manual- Centers for Disease Control and Prevention. Available from [https://www.cdc.gov/nchs/data/nhanes](https://www.cdc.gov/nchs/data/nhanes). Accessed 20/5/2022
Musa DI, Goon DT, Okuneye RO, Onoja-Alexander MO, Momoh JI, Angba TO. Visceral adiposity index, fitness and clustered cardiovascular disease risk in adolescents. Afr J Prm Health Care Fam Med. 2024;16(1), a4474. [https://doi.org/10.4102/phcfm.v16i1.4474](https://doi.org/10.4102/phcfm.v16i1.4474)
Xi B, Zong X, Kelishadi R, Litwin M, Hong YM, Poh BK, et al. International Waist Circumference Percentile Cut-offs for Central Obesity in Children and Adolescents Aged 6 to 18 Years. J Clin Endocrinol Metab. 2020 Apr 1;105(4):e1569–83. doi: 10.1210/clinem/dgz195. PMID: 31723976; PMCID: PMC7059990.
Chinyere Nkiruka Asoegwu, Nkiruka Augusta Wakwe, Janet Ngozi Ajuluchukwu, Clement Chukwuemeka Nwawolo, Relation between Elevated blood pressure and Hearing Loss: A Study of Hypertensive Patients in a Tertiary Hospital in Lagos, Nigeria, Nigerian Postgraduate Medical Journal, 33, 1, (134-139), (2026).
Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesha. Niger J Paediatr. 1985; 12:111-117.
Nkeh-Chungag BN, Sekokotla AM, Sewani-Rusike C, Namugowa A, Iputo JE. Prevalence of elevated blood pressure and preelevated blood pressure in 13-17-year-old adolescents living in Mthatha - South Africa: a cross-sectional study. Cent Eur J Public Health. 2015 Mar;23(1):59-64. doi: 10.21101/cejph.a3922. PMID: 26036100.
Bonita F. Children and adolescents with obesity-associated high blood pressure. Journal of the American Society of Elevated blood pressure 2008; 2: 267-274 [https://doi.org/10.1016/j.jash.2008.01.003](https://doi.org/10.1016/j.jash.2008.01.003). ([https://www.sciencedirect.com/science/article/pii/S1933171108000053](https://www.sciencedirect.com/science/article/pii/S1933171108000053)
Falkner B. Monitoring and management of elevated blood pressure with obesity in adolescents. Integr Blood Press Control. 2017 Nov 20;10:33-39. doi: 10.2147/IBPC.S125094. PMID: 29200886; PMCID: PMC5700763.
Jeong SI, Kim SH. Obesity and elevated blood pressure in children and adolescents. Clin Hypertens. 2024 Sep 1;30(1):23. doi: 10.1186/s40885-024-00278-5. PMID: 39217385; PMCID: PMC11366140.
Wahid, N. A. A. (2024). Impact of Body Weight on Blood Pressure Among University Students. Randwick International of Education and Linguistics Science Journal, 5(4), 1338-1349. [https://doi.org/10.47175/rielsj.v5i4.1096](https://doi.org/10.47175/rielsj.v5i4.1096)
Sabaka P, Dukat A, Gajdosik J, Bendzala M, Caprnda M, Simko F. The effects of body weight loss and gain on arterial elevated blood pressure control: an observational prospective study. Eur J Med Res. 2017 Oct 25;22(1):43. doi: 10.1186/s40001-017-0286-5. PMID: 29070064; PMCID: PMC5655940.
Yusni Y, Rahman S, Naufal I. Positive correlation between body weight and body mass index with blood pressure in young adults. Narra J. 2024 Apr;4(1):e533. doi: 10.52225/narra.v4i1.533. Epub 2024 Apr 30. PMID: 38798838; PMCID: PMC11125317.
Luisa María Sánchez-Zamorano, Eduardo Salazar-Martinez, Rafael Anaya-Ocampo, Eduardo Lazcano-Ponce. Body mass index associated with elevated blood pressure in Mexican school-aged adolescents, Preventive Medicine 2009; 48; 543-548. [https://doi.org/10.1016/j.ypmed.2009.03.009](https://doi.org/10.1016/j.ypmed.2009.03.009).
Kringeland E, Tell GS, Midtbø H, Haugsgjerd TR, Igland J, Gerdts E. Factors associated with an increase in blood pressure and incident elevated blood pressure in early midlife: the Hordaland Health Study. Blood Pressure 2020; 29(5): 267–275. [https://doi.org/10.1080/08037051.2020.1762070](https://doi.org/10.1080/08037051.2020.1762070)
Niba LL, Navti LK, Musa AJ. Relationship between measures of adiposity and elevated blood pressure amongst secondary school adolescents in an urban setting in Cameroon. Pan Afr Med J. 2023 Oct 17;46:57. doi: 10.11604/pamj.2023.46.57.41547. PMID: 38223873; PMCID: PMC10787134.
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