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Open Access Highly Accessed Research article

Waist circumference and risk of elevated blood pressure in children: a cross-sectional study

Cheuk-Sing Choy12, Wan-Yu Chan3, Ta-Liang Chen45, Chun-Chuan Shih6, Li-Chu Wu7 and Chien-Chang Liao458*

Author Affiliations

1 Emergency and Intensive Care Department, Taipei Hospital, Department of Health, Executive Yuan, Taiwan

2 Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan

3 Department of Nursing, Min-Hwei College of Health Care Management, Tainan 736, Taiwan

4 Department of Anesthesiology, Taipei Medical University Hospital, Taipei 110, Taiwan

5 Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei 110, Taiwan

6 The School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung County 82445, Taiwan

7 Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 100, Taiwan

8 Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan

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BMC Public Health 2011, 11:613  doi:10.1186/1471-2458-11-613

Published: 2 August 2011



Increasing childhood obesity has become a major health threat. This cross-sectional study reports associations between schoolchildren's waist circumference (WC) and risk of elevated blood pressure.


We measured height, weight, neck and waist circumference, and blood pressure in regular health examinations among children in grade 1 (ages 6-7 years) at six elementary schools in Taipei County, Taiwan. Elevated blood pressure was defined in children found to have mean systolic or diastolic blood pressure greater than or equal to the gender-, age-, and height-percentile-specific 95th-percentile blood pressure value.


All 2,334 schoolchildren were examined (response rate was 100% in the six schools). The mean of systolic and diastolic blood pressure increased as WC quartiles increased (p < 0.0001). The prevalence of elevated blood pressure for boys and girls within the fourth quartile of waist circumference was 38.9% and 26.8%, respectively. In the multivariate logistic regression analyses, the adjusted odds ratios of elevated blood pressure were 1.78 (95% confidence interval [CI] = 1.13-2.80), 2.45 (95% CI = 1.56-3.85), and 6.03 (95% CI = 3.59-10.1) for children in the second, third, and fourth waist circumference quartiles compared with the first quartile. The odds ratios for per-unit increase and per increase of standard deviation associated with elevated blood pressure were 1.14 (95% CI = 1.10-1.18) and 2.22 (95% CI = 1.76-2.78), respectively.


Elevated blood pressure in children was associated with waist circumference. Not only is waist circumference easier to measure than blood pressure, but it also provides important information on metabolic risk. Further research is needed on effective interventions to identify and monitor children with increased waist circumference to reduce metabolic and blood pressure risks.

Children; obesity; elevated blood pressure; waist circumference