Elevated blood pressure, cardiometabolic risk and target organ damage in youth with overweight and obesity

Procolo Di Bonito, Lucia Pacifico, Maria Rosaria Licenziati, Claudio Maffeis, Anita Morandi, Melania Manco, Emanuele Miraglia del Giudice, Anna Di Sessa, Giuseppina Campana, Nicola Moio, Marco Giorgio Baroni, Claudio Chiesa, Giovanni De Simone, Giuliana Valerio, Claudia Forziato, L. Gilardini, Sandro Loche, Gianluca Tornese

Research output: Contribution to journalArticlepeer-review


Background and aim: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. Methods and results: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP ≥ 90th to <95th percentile for age, gender and height in children or BP ≥ 120/80 to <130/80 in adolescents. The overall prevalence of elevated BP was 18.3%, and significantly increased from normal-weight to obese youth. Young people with elevated BP showed higher levels of body mass index (BMI), insulin resistance and a higher prevalence of liver steatosis (45% vs 36%, p < 0.0001) than normotensive youth, whilst they did not differ for the other cardiometabolic risk factors, neither for carotid intima media thickness or left ventricular mass. Compared with normotensive youth, individuals with elevated BP had an odds ratio (95%Cl) of 3.60 (2.00–6.46) for overweight/obesity, 1.46 (1.19–1.78) for insulin-resistance and 1.45 (1.19–1.77) for liver steatosis, controlling for centers, age and prepubertal stage. The odds for insulin resistance and liver steatosis persisted elevated after correction for BMI-SDS. Conclusion: Compared to normotensive youth, elevated BP is associated with increased BMI, insulin resistance and liver steatosis, without significant target organ damage.

Original languageEnglish
Pages (from-to)1840-1847
Number of pages8
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number10
Publication statusPublished - Sep 24 2020


  • Adolescents
  • Carotid intima media thickness
  • Children
  • Elevated blood pressure
  • Left ventricular mass
  • Liver steatosis
  • Obesity
  • Overweight

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine


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