Is There a Relationship between BMI and Blood Pressure In Children Ages 5-12?

Jackson, Almeta, Kathy Moore, Tameaka Roundtree, and Carla Groh

Background: Obesity has become a major health concern in the United States and is associated with the development of chronic illnesses. According to the Center for Disease Control and Prevention (CDCP), obese children and adolescents are more likely to have risk factors associated with high blood pressure, high cholesterol, and Type 2 diabetes than non-obese children and adolescents (CDCP, 2011).  A fast paced society has created technology that rapidly progresses while funding for physical activity programs in schools continues to be cut. Thus, society is becoming more sedentary and overweight. There is a need for resources and programs that help children to achieve healthy weights which address issues such as poverty and the inability to maintain a healthy lifestyle. According to Ruiz, Ortega, Loit, Veidebaum and Sjostrom (2007) high blood pressure is an established risk factor for cardiovascular disease.  Epidemiological evidence suggests that essential hypertension and the precursors of cardiovascular disease originate in childhood (Ruiz et al., 2007).

Aim: The purpose of this study is to examine the relationship between body mass index (BMI) and blood pressure (BP) in children ages 5 to 12 in an urban primary care clinic. 

Methods: This study is a correlational descriptive design. Data were obtained using a retrospective electronic medical record (EMR) review conducted at a nurse managed clinic in an urban setting. The study was approved by the University of Detroit Mercy’s Institutional Board in Detroit, Michigan.  Medical records of children 5 to 12 years who had seen the nurse practitioner for a health visit from 2008 to 2011 were included if they had BP and BMI readings recorded. 

 

Results: Sixty children, mostly African American, met criteria for study inclusion for a total of 84 nurse practitioner visits. The mean age for all children was 7.6 years, with a mean BMI of 20.2, mean systolic blood pressure (SBP) of 98.7 and mean diastolic blood pressure (DBP) of 63.7.  The mean weight for the girls was 85.7 (SD 47.6) and 69.5 (SD 26.1) for boys. This difference was statistically significant (p=.32). The majority of the visits were well-child visits (n=71). 

The relationship between BMI and SPB was statistically significant (p=.001) as was the relationship between BMI and DPB (p=.009).

Implication to Nursing Practice: The finding of this study supports that there is a significant relationship between BMI and BP in children as young as 7.6 years. One finding that merits further exploration is that the girls in this study weighed 16 pounds more than the boys who were the same age.  Early nursing interventions must be considered if the risk of childhood obesity and the subsequent co-morbidities in adolescents and adults are to reduced.  Clinicians must be vigilant in identifying and educating patients on modifiable and non-modifiable risk factors and lifestyle changes that can reduce poor health outcomes.