A waist-to-height ratio > 0.5 was independently associated with elevated blood pressure in children and adolescents (OR 2.14; 95% CI 1.32-3.47; p=0.002).
Cross-Sectional (n=810)
No
Are anthropometric indicators like waist-to-height ratio and lifestyle factors associated with elevated blood pressure in children and adolescents?
Waist-to-height ratio is a more sensitive early marker of cardiometabolic risk than BMI alone in children and adolescents, independently predicting elevated blood pressure.
Odds Ratio: 2.14 (95% CI 1.32–3.47)
p-value: p=0.002
Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention.
Lodi et al. (Thu,) conducted a cross-sectional in Cardiometabolic risk (n=810). Waist-to-height ratio > 0.5 vs. Waist-to-height ratio ≤ 0.5 was evaluated on Elevated blood pressure (OR 2.14, 95% CI 1.32-3.47, p=0.002). A waist-to-height ratio > 0.5 was independently associated with elevated blood pressure in children and adolescents (OR 2.14; 95% CI 1.32-3.47; p=0.002).