Children with obesity or severe obesity were significantly more likely to have high blood pressure than children with normal weight, based on new data from nearly 1000 children collected at youth community screenings.

Although the connection between obesity and high blood pressure is well-known, quantifying data in children are limited, said lead author Patrick Faherty, a student at Sidney Kimmel Medical College in Philadelphia, in an interview. “Specifically, we were interested in quantifying this connection in children from the Philadelphia area,” he said. Knowing how the odds of having a particular condition increase or decrease based on certain factors is more powerful and tangible information than simply knowing that a connection exists, he said.

In a study presented at the American Heart Association’s Hypertension Scientific Sessions (HYP) 2025, Faherty, fellow medical student William Brincheiro, and colleagues analyzed data on systolic blood pressure and BMI from youth community blood pressure screenings in the Philadelphia area between 2023 and 2025. The study population included 920 children aged 3-18 years; approximately 70% were aged 14-17 years. Each participant was classified as either having low/normal systolic blood pressure or elevated systolic blood pressure and as having underweight/normal weight, overweight, obesity, or severe obesity, according to age-related guidelines. A total of 17 participants were classified as having underweight, 414 as having normal weight, 156 as having overweight, 268 as having obesity, and 65 as having severe obesity.

Overall, children with overweight were not significantly more likely than those with underweight/normal weight to have elevated systolic blood pressure, according to a multivariate regression analysis (P = .709). However, children with obesity or severe obesity were 2.043 and 3.9 times more likely, respectively, than their peers with underweight/normal weight to have elevated systolic blood pressure (P < .001 for both categories).

Notably, the study used the National Heart, Lung, and Blood Institute guidelines for elevated blood pressure, which uses age-specific guidelines. These guidelines yield a higher proportion of individuals identified as having high blood pressure than studies utilizing the simpler static guidelines more often used in pediatric practice, the researchers wrote.

As for additional research, a prospective study to examine the relationship between BMI and blood pressure elevation would be helpful, Faherty said. “Looking at other factors aside from BMI could be very telling,” he added.

The magnitude of the odds ratios was in-line with other studies in pediatric populations, Faherty told Medscape Medical News. “However, I was surprised that there was not significant statistical evidence that being overweight alone increased the odds of having elevated systolic blood pressure,” he said. “It seems that, at least in our study population, the odds of having elevated systolic blood pressure did not increase until passing the obese and severe obesity threshold,” he added.

For clinicians, the study findings underscore the importance of childhood obesity interventions, said Faherty. “With odds increasing approximately twofold and fourfold for having elevated systolic blood pressure for children with obesity and severe obesity, respectively, it is clear that this is an opportunity for intervention that could greatly affect pediatric hypertension, which in turn is a significant risk-factor for adult hypertension, he emphasized.

Clinicians: Keep Working to Reduce Childhood Obesity

“As cardiovascular disease remains a leading cause of adult morbidity and mortality, efforts to reduce obesity in children should remain a top priority,” said Tim Joos, MD, a clinician with a combination internal medicine/pediatrics practice at Neighborcare Health in Seattle, in an interview.

“I think everyone could predict the observed results that the obese and severely obese children had a significantly higher odds of high blood pressure,” said Joos, who was not involved in the study.

The study’s limitations included the use of BMI, which can be inexact, especially in individuals with high muscle mass, Joos noted.

However, the finding that children who had overweight, though not obesity, didn’t show a significant stepwise increase in blood pressure was surprising, Joos told Medscape Medical News. This finding suggests the possibility of a BMI/body fat threshold that must be met before blood pressure begins to rise consistently, he noted.

This study was supported in part by Simon’s Heart, a nonprofit organization that coordinated all the community-based screenings. The researchers had no financial conflicts to disclose. Joos had no financial conflicts to disclose.