Comparison between waist and mid-upper arm circumferences in influencing systolic blood pressure in adolescence: the SHARP (Sardinian Hypertensive Adolescent Research Programme) study

Pier Paolo Bassareo, Andrea Raffaele Marras, Claudio Barbanti, Giuseppe Mercuro


Background: The correlation between high blood pressure (BP) and overweight in children is widely acknowledged, although the role of body fat distribution in this association remains to be fully elucidated. The aim of this study was to investigate the role of abdominal (central) and mid-upper arm (peripheral) adiposity in association with BP.

Methods: 839 adolescents of both genders took part in the SHARP (Sardinian Hypertensive Adolescent Research Programme) study. BP, waist circumference (WC), mid-upper arm circumference (MUAC), body mass index (BMI) and heart rate were measured.

Results: 89 out of 839 subjects were hypertensive (10.6%: 44 males and 45 females. Isolated systolic hypertension: 4.2%; isolated diastolic hypertension: 4.9%; combined systolic and diastolic hypertension: 1.5%). In univariate analysis, WC and MUAC correlated with systolic (p < 0.0001 and p < 0.0007, respectively), but not with diastolic BP. In multiple longitudinal regression analysis, WC and MUAC were the strongest independent predictors of systolic BP over time. Furthermore, a significant increase of systolic BP was observed throughout all age-adjusted quintiles of WC (p < 0.001), while a similar increase was revealed only for the first four quintiles of MUAC (p < 0.001). Higher quintiles of central adiposity were associated with a higher prevalence of elevated systolic BP (p < 0.001), while no similar relationship was detected for MUAC.

Conclusions: in adolescence, central and peripheral distribution of body fat is associated with normal systolic BP, irrespective of BMI, with WC alone being correlated to hypertension.


Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy) · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research


blood pressure; hypertension; body fat; pediatrics

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