Waist Circumference as a Predictor of Pediatric Hypertension Among Normal-Weight Taiwanese Children

Background: Although the association between increased waist circumference (WC) and hypertension has been established in adults, it has not been thoroughly studied in Asian children. The present study investigates the association between WC and hypertension risk in normal-weight children and subsequently examines the ability of WC to effectively predict hypertension in 7-year-old Taiwanese children. Design: The body height, weight, neck circumference, WC, and blood pressure (BP) data of 2253 of 7-year-old elementary school children (1^st grade) were collected. Methods: BP was measured twice, and prehypertension and hypertension were defined as mean systolic and/or diastolic BP greater than or equal to 90^th or 95^th percentile, respectively, according to sex, age, and height (as defined by standard U.S. BP tables). Results: The prevalence of prehypertension and hypertension across all subjects was 10.47% and 18.11%, respectively. The gender-adjusted odds ratio [95% confidence interval (CI)] of hypertension associated with a 1-standard deviation higher level of WC was 2.13 (95% CI: 1.75-2.59) for normal-weight children; 1.88 (95% CI: 1.31-2.71) for overweight children; and 1.72 (95% CI: 1.15-2.57) for obese children. Regarding hypertension status, the areas under the receiver operating characteristic curve for body mass index and WC were 0.64 and 0.69, respectively. Conclusion: The results of this study suggested that WC is a simple measurement that may be more efficient than body mass index in predicting the risk of pediatric hypertension among normal-weight, 7-year-old children.