Population-Based Examination of the Interaction of Primary Hypertension and Obesity in South Carolina

Recent studies have demonstrated that the prevalence of primary hypertension (HTN) among children is higher than early estimates of 25%. The prevalence of obesity has more than doubled between 1980 and 2000, from 5% to 11%. To examine racial differences in the prevalence and progression of comorbid essential HTN and obesity for children 0 to 21 years of age, onset age distribution, controlling for widely acknowledged gender differences, a statewide Medicaid claims database was used. Results indicate that the prevalence rate of HTN in the general pediatric population treated during the decade between 1995 and 2004 with Medicaid was 3.7% for essential HTN, or 90% of the total diagnosed HTN cases. Just more than half were first diagnosed with HTN with no gender or ethnic differences, mean age of onset was 14 to 15 years of age for HTN and 12 to 15 years of age for obesity, but with the mean age of onset for both conditions increasing with time. Development of the comorbid conditions takes less than 2 years regardless of which condition is diagnosed first. African Americans demonstrate more rapid onset of obesity when HTN is diagnosed first, and both males and African Americans show more rapid onset of HTN when obesity is diagnosed first. This study is the first population-based study to include such a large cohort of pediatric patients who are both hypertensive and obese with information during 10 years. Pediatric males and African Americans are important groups to monitor closely in the diagnostic and treatment phases for comorbid HTN and obesity.